One of the most controversial issues of the current health care reform debate is the concept of health care rationing-allocating medical care according to predetermined criteria that dictate how much and what kind of care a given patient will receive under a government-run system. Setting aside the comparative merits of various reform proposals on the table in Congress, Americans-particularly the elderly-should be wary of any plan that would limit access to health care based on the arbitrary and discriminatory criteria of age.
As many have pointed out in the course of the ongoing national discussion on health care, America's population is aging rapidly, placing a growing strain on entitlement programs like Medicare and Social Security. Health care costs continue to rise, and America's younger population cannot long foot the bill for elderly retirees and their significant health care requirements. This conundrum (caused not by taxpayers but by decades of gross government mismanagement of taxpayer dollars) seems to have bred an underlying antipathy towards seniors, the undisputed "resource hogs" of public health care. This feeling of resentment is exacerbated by an increasingly utilitarian view of human life that sees no value in prolonging one's twilight years, especially on the public dime.
This situation makes proposals for "comparative effectiveness" research seem like a pretty good idea. Who, after all, wants to waste their taxpayer dollars on treatment for old folks who are going to die soon anyway? Wouldn't it be better to allocate the bulk of our health care resources towards more productive members of society while reducing the spectrum of costly options available to seniors and the terminally ill among us?
But do Americans really want government bureaucrats dictating access to care based on their perception of one's worth to society? This question goes to the heart of the problem with rationing: a stranger far from the scene decides who gets care and who doesn't. The person making these decisions knows neither the patient nor the healthcare provider, yet he or she is charged with the responsibility of allocating scarce resources among a demanding population rather than providing the best possible care.
Instead of allowing the market to dictate cost and availability, the buck will stop with the government. Instead of allowing doctors to work dynamically with their patients to tailor a health care approach best suited to the individual in question, the government will use its regulatory power to force physicians into applying narrow "quality of life" criteria when evaluating treatment options for society's elderly citizens. This utilitarian approach to life and death is already affecting seniors in North America, in places like Canada (no surprise there), Texas, and Wisconsin.
A health care system that bases its fiscal solvency on rationing undermines the fundamental American values of self-determination and choice. This nation has always been known as a land of opportunity and innovation. For hundreds of years, people have traveled from all over the globe at risk to life and limb just for a chance to build their own dreams here in America. This includes the opportunity to live a full and free life, even into one's golden years of retirement and senior citizenship. But what criteria will America's elderly citizens have to meet in order to retain access to the best health care if our leaders institute a Brave New World of "comparative effectiveness" in health care? Age? Productivity? Societal "usefulness?" Level of sentience?
The elderly often don't score well along these lines, and once American society becomes comfortable with the idea that certain members may be deemed less worthy than others in the eyes of the government, we have rendered the heart and soul of our Constitution meaningless. Once we decide that the elderly are expendable, not worth their share of society's resources and attention, we are setting a dangerous precedent that opens the door for government bureaucrats to assign other vulnerable members of the human community to the same second-class status.
The idea that senior citizens are less deserving of the best medical care our system has to offer smacks of gross ignorance and ingratitude. Among the ranks of America's elderly are countless American heroes-veterans of numerous wars, entrepreneurs, farmers, businessmen, teachers, scientists... men and women who have worked hard and paid taxes their whole lives. Our society wouldn't be what it is today without their contributions, and they deserve just and equitable treatment as they live out their final years.
As the August recess commences and our leaders head home for some straight talk with their constituents at Rotary Clubs, community centers, and town halls, hopefully they will recognize that America's seniors are vital members of our nation's communities and integral to our democratic way of life. If Uncle Sam is determined to assume the mantle of responsibility for health care in America, the elderly should not automatically be relegated to the back of the bus.