To the editor:
Your editorial of Jan. 17 on manipulation of the health care issue by politicians is, I believe, a point well taken. Any knowledgeable health care provider or consumer must be concerned about the rising cost of health care and its impact not only on the individual but on our economy as a whole and our ability to compete in many world markets. Unfortunately, this is becoming a political issue which lends itself to distortions and omissions of fact in the political arena.
When Rep. Jim Slattery (whom I happen to support on many issues) held his "town meeting," it seemed to me that he was taken back and surprised by the many people in the audience who recognized that "rationing," supposedly a no-no word in political circles, is a necessary part of cost containment. He outlined three general categories in which the 30 or so current proposals floating around the halls of Congress fall. Each contain the element of cost control.
At first blush, it would appear that cost control simply means cutting the fees paid to hospitals, nursing homes, doctors and pharmaceutical companies. But it takes a little sophistication to realize that cost contains two elements the price for each unit of service and the number of units of that service rendered. The control of the number of units of service rendered is rationing. It goes on now in limiting coverage for Pap smears, mammograms, length of hospital stays and skilled nursing days, etc. Sen. Kassebaum's proposals for coverage for "basic services" means rationing of full services. Every other country in the world who has government-provided health care has rationing.
Rather than ignoring the realities of health care financing, it's time that all of us, including politicians, addressed this issue in public discussion so that rationing can be rational! How we spend this nation's health care dollar is of vital concern to us all.
Phillip A. Godwin, M.D.,