Irrational Discourse

At press time, it was not yet clear whether or how much the negotiations on the federal debt ceiling would hurt Medicare. But one thing is certain: Intense debate will continue about how to control Medicare costs, and it will include heated rhetoric about "rationing" health care.  But where a normal definition of "rationing" would be "the equitable distribution of scarce resources," the health-care system in the United States is the polar opposite: It inequitably distributes abundant resources. And the people who raise the loudest accusations are actually promoting an increase in this unjust kind of rationing.

The U.S spends twice as much as other developed countries on health care, while leaving 50 million people without any coverage, resulting in the premature death of 45,000 people a year. Tens of millions more people are sicker because they don't get the care they need; many people suffer under crushing medical debt.

Rep. Paul Ryan's Republican budget proposals in April, some form of which we may be debating until next year's election and beyond, would extend that bleak picture to the 43 million Americans who rely on Medicare. Ryan's plan would double out-of-pocket costs to seniors over the coming decade -- while enriching private insurance companies. The House Republican budget plan also sought to ration care by capping federal spending on the 69 million seniors and family members who rely on Medicaid and by ending the 2010 health-care reform law's expansion of health coverage to 32 million uninsured people.

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