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Should Healthcare Be Rationed? PRO and CON

Posted Jul 17 2009 10:51pm

In next week'sU.S. NEWS & WORLD REPORT, is a pro-con debate over whether healthcare should be rationed. Some, like Michael Tanner at the Cato Institute, "say Americans use too much healthcare, that even if reform is achieved, universal access should not mean unlimited access. Tough choices must be made." Others, likeLaura Hershey (anEnglewood,Colo.advocate for the rights of the handicapped) "worry that the most needy or least able to fight for themselves will be left waiting."

Hershey is disabled. She is bathed, dressed, and fed by personal care assistants. She operates her wheelchair by blowing into a tube. She is concerned that "doctors will stop short of saving" lives like hers.

She observes that many state laws "allow doctors to unilaterally deny lifesaving treatments that they deem 'futile,' even if the patient or a surrogate decision maker wants care continued." (Of course, as I have written, most of those laws "allow" unilateral denial only in word, not in effect.)

Hershey writes that some "nondisabled people think that having a disability is an intolerable state and that medical care can't be considered efficacious unless it restores lost physical or mental functions." Consequently, the disabled fear that medical practitioners will stop short of saving their lives.

I take Hershey's concerns very seriously. They are backed by data. That is why Ihave writtenand am continuing to write about procedural fairness in end-of-life decisions. I am optimistic that desired treatment can be refused without engaging in disability discrimination.

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