Its really the underlying basic principle of economics: any scarce resource is, inevitably, rationed; differences in economic systems are about how rationing is done, not whether it is done.

Any time someone suggests that one choice will lead to rationing, they are deceiving by omission with the suggestion that without the choice, rationing will not occur.

it is obscene how conservatives can consider the suffering and death of people -- of children -- as a perfectly fine trade-off with regard to MAKING PROFIT, and then project their own inhuman values onto fantasy-like government expectations... you know like they always do...

gospel of ronnie rayguns, par excellence!

I just got my insurance premium statement yesterday from my lousy United Healthcare plan. Yep, they're raising it again. I'm in perfect health and haven't used the insurance even once since getting on the plan 2 1/2 years ago. Yet, this will be the the 3rd time they've raised the premium. I'm now going to have to pay 64% more for the same coverage I had when starting the plan. A 64% increase in 2 1/2 years! You've got to be f*cking kidding me.

The friendly people at United Healthcare assure me they value my business and are "working hard to provide our policy-holders with quality insurance at an affordable cost. In spite of our efforts, medical costs continue go up due to increased use and higher charges for health-care products and services. New technology and procedures often improve the quality of care but also contribute to rising cost." This is the same bullshit excuse they've used every time. Are hospitals and doctors offices charging 64% more today than they did at the beginning of 2007?

Sadly, I know if I actually have to use this insurance, I'll have to hire a lawyer to pry the coverage I'll need out of United Healthcare's grubby little greedy hands.

gee whiz, i'm sorry i miss out on all that, "about time."

as a member of the uninsured... i really hunger to stand at the toilet and flush twenties down it for ever -- or until my rotor cuff acts up...

A few months ago, in Inside Washington, a local TV show, CK said the same about how we already ration. I guess why allow the truth to get in the way of some good demagoguery.

Taking this one step further - we decide to spend our tax dollars, a limited resource, on, say a $650b military instead of healthcare for every American. That's a choice. Why we do that is because of the influence of corporate America in the industrial military complex. Why we don't spend on the money on healthcare has the same answer - powerful companies influencing the government not to get involved. Just once I'd like to see someone on the Right explain to me how our military spending isn't open corporate welfare, aka socialism.

gee whiz, i'm sorry i miss out on all that, "about time." as a member of the uninsured... i really hunger to stand at the toilet and flush twenties down it

I'm sorry you don't have insurance neill.

I guess I failed to mention how my experience relates to rationing. I have the high deductible insurance the Republicans are so fond of. In theory, I'm covered for a catastrophic medical event, but all of my non-catastrophic health-care is out of pocket. I don't get physicals or check-ups, I don't even have a primary care physician. I ration. And now it looks like I'll have to ration even more.

There was a time when right wing reactionaries like Krauthammer were permitted to be more open in their contempt for democracy and government of, by and for the people. There was a time not that long ago when the accepted argot of the times allowed the ruling classes to use "democracy" as just another word for "mob rule." England, after all, did not give the franchise to its people until 1864, and then it was a rather limited francise that did not extend the vote to all English males until just before World War I. Here in enlightened America, our ruling classes and social conservatives did not give the francise to women until 1919.

Conservatives like Krauthammer like it that way. They think societies descend into anarchy and perdition whenever the masses get too much power. They think that nations are ruled best when real power is confined in a very few hands of approved authorities. In other words, an oligarchy.

Of course, in the 21st century it's not politically correct to attack democracy directly, so conservatives over the past 20 years have used their control of a power conservative media echo chamber to skillfully undermine faith in democracy by using "government" as their proxy target. No one likes to pay taxes, and conservatives know it. Most people are fearful of power, especially concentrated power, and conservatives know that too. But most people are attached to the rights guaranteed them by our constitution and government, so conservatives know it would be a fools errand to wage a frontal assault against democracy. They cannot do what their reactionary forebearers did long ago and question the ability of any nation to be self-governing.

So conservatives do the next best thing. They attack "government," usually accompanied by the ubiquitous adjective "Big." Watch any show on FOX or listen to talk radio and you can't miss the the implication that every announcer understands immediately that using the word "government" undermines the confidence and credibility in any program they are talking about. It took a lot of time and billions of dollars by a small group of right wing oligarchs to accomplish that result.

Reactionaries know they can't attack democracy so they attack the only instrument we have that is capable of carrying out the public's will and protecting us from the exploitation of those conservative elites that Krathammer gets paid a livable wage for protecting. Ever since Ronald Reagan in 1980, the conservative project has been defined as an attempt to transfer power from a popularly-elected democracy to an unelected and unaccountable oligarchy that feels itself better able to rule this country than is "the mob." And most perverse of all, this conservative campaign to re-enslave the public by making it captive to the interests of a powerful oligarchy has been waged in the name of advancing "freedom." With time and repetition and the aid of a powerful conservative media, tens of millions of Americans have been convinced that their government -- the one they control and put into power -- is not a protector of their rights but a source of their oppression.

Ronald Reagan announced this anti-democratic agenda on his very first day in office when he said in his inaugural address that government was not the solution to our problems, it was the problem. America's right wing has spent billions of dollars over the past 20 years saturating the airwaves day and night with the idea that government -- and by extension, democracy -- is a source of enslavement. They've largely succeeded. In 1964, about 60 percent of Americans expressed confidence in THEIR government. Today, after 24/7 attacks on the very idea of A PUBLIC existing apart from private self-interest, FOX and others have been able to drive down faith in government to about 19%.

And once you've destroyed faith in the very idea of a "democratic public" that excercises power through government, all sorts of other opportunities open up to you to protect the vested interested of the oligarchy. It is, for example, relatively easy for conservatives like Krauthammer to justify the continued exploitation of Americans by a predatory health care industry whose profits have gone up 400% in the last seven years alone thanks to the monopoly they enjoy to deny health care to folks who pay these companies thousands of dollars a year to get that care, by using words like "rationing" to raise the spector of a tyrannical Big Government that sits in judgment like some all-powerful, powdered-wig Star Chamber over the health care needs of millions of Americans.

"We do not see first and then define," said Walter Lippmann long ago about why it is so easy to manipulate public opinion, "we define first and then see." Conservataves have successfully confined a sizable chunk of the American public to see its own enslavement as "freedom." The first task of liberal Americans who care about the future of our democracy is to retake the language from this right wing, deconstruct the perverse memes and messaging it has used, and neutralize the clever propaganda that has turned millions of Americans into sheep being readied for the slaughter

With all the misinformation and lies coming from the right-wing side it is impossible to get down to any intelligent debate. Rationing is just common sense use of resources. Rationing in the private sector is more like maximizing profit.

It would help if people against single payer or at least PO would know what they would gain. Would the public option be portable, cover people with pre-conditions, would not stand between the doctor and patient and would not require pre-approval for treatment, would it cover care of handicapped people for life, would there be no rescission? Will there be choice of doctors? How will prescription drugs be handled and will there deductibles? Will the PO be affordable and will there be government help for low income people to pay?

Medicare does answer many of these questions, but it would help if the Democrats would hammer home the advantages instead of always going defensive and making concessions.

If there is no PO, will the administration and the Democrats have enough back bone to regulate the insurance? Obviously not, that is why Obama said we need a PO to keep them honest. A PO must offer more than the privates, it must be better and the people need to be told pronto. To prevent the PO from being better than the privates to allow them to be competitive and make huge profits would be no reform at all.

Of course, they could pull a fast one and use PO as a pool for high-risk patients at taxpayers expense. That would cover people with pre-conditions unable to get insurance now.

Looking back, it would have been easier to just include singles earning less than say $60.000 families earning less than say $120.000 and people unable to get insurance for affordable premiums in Medicare. But that would be close to single payer for all and not permitted by the industry.

"It's a subject the country ought to be to look at intelligently. It's not. We're stuck having a debate with the public discourse we have, not the public discourse we might want or wish to have at a later time."

I would be happy if we could simply have a debate about health care, starting from some kind of agreement that Americans are not getting good value for our health care dollars: We pay twice as much as anyone else, yet we have so many people without healthcare and our outcomes (longeveity, infant mortality, etc) are worse than in other advanced nations.

Instead we have one side arguing about the need for health care reform, and the other side again focused solely on their one idea, that government is the problem. All their arguments about health care are really just red herrings.

bet bailey had to look thru 18 dictionaries before he found a definition w/the word "government" in it. why not websters? why not funk & wagnalls?

dictionary.com sez rationing is:

ra•tion (r�sh'ən, r�'shən) n. 1. a fixed portion, especially an amount of food allotted to persons in military service or to civilians in times of scarcity. 2. rations food issued or available to members of a group. tr.v. ra•tioned, ra•tion•ing, ra•tions

1. to supply with rations.
2. to distribute as rations: rationed out flour and sugar. see synonyms at distribute.
3. to restrict to limited allotments, as during wartime.

[french, from latin rati�, rati�n-, calculation; see ratio.]

nowhere does the word "government" appear. the closest thing is "military."

Krauthammer, like all conservative "intellectuals", styles himself so very savvy about economic theory and reality - versus the starry-eyed Bambi liberal dreamers etc. So he above all, should know and acknowledge that basic economic theory says we compete with dollars for scare resources. In a "free market" those resources are indeed rationed - by cost. No "educated" person can get away with pretending they don't know that health care is already rationed.

[sockpuppeting is prohibited on this blog Gary/Simpson/et al -- mod.]

[sockpuppeting is prohibited on this blog Gary/Simpson/et al -- mod.]

Personal stories from people within the system reveal the human side of these statistics. In 2005, Ta'Shon Rain Little Light, a 5-year-old member of the Crow tribe who loved to dress in traditional clothes, stopped eating and complained that her stomach hurt. When her mother took her to the IHS clinic in south central Montana, doctors dismissed her pain as depression. They didn't perform the tests that might have revealed the terminal cancer that was discovered several months later when Ta'Shon was flown to a children's hospital in Denver. "Maybe it would have been treatable" had the cancer been discovered sooner, her great-aunt Ada White told the Associated Press.

Given how similar that story is to how Henry Louis Gates ended up with one leg shorter than the other in West Virginia in 1964, I don't think it signifies what the writer thinks it does. Hint: the problem is not with who was funding the healthcare.

I guess it is too bad that the democrats didn't just organize a health care event instead of a town hall. They could have contacted doctors in their districts, organized a clinic and showed up to talk one-on-one with people who need health care to be more affordable.

It would have been a marked contrast or countermeasure to the angry mobs who claim the system is working right now and we don't need change.

Ted Frier, that piece was great. Must be yours so please try to put a polished ver. up somewhere, maybe Truthout (not just Kos diary which is OK but "articles" have more cachét.)

To sharpen your point: Right-wingers want everyone to single-mindedly focus on "the government" and direct political activities per se, so people won't ask: how are the other (private) institutions treating me?

Ezra's numbers are misleading.

If you're truly in danger in Canada, you don't wait.

If you can't afford your HI premiums, you get health care anyway.

I read so much misinformation about Canada's system, from experts as well as morons, from the well-intentioned as well as the obstructionists,

We're just across the border, folks, and all of our rules and regulations are well-documented.

Pardon that comma...

Neil B

Thanks for the comments and thanks for the suggestions on further distribution.

You got my point exactly. Conservatives try to frame the issue very simply: the absence of government is freedom. And who doesn't like that? This equation sells very well with most people since we all hate paying taxes and like freedom from restraint. Yet, the reality is more complex. Power abhors a vacuum and the absence of DEMOCRATIC government is not enhanced freedom for the individual necessarily. Often government's retreat results in the transfer of real governing power from the state to private oligarchies -- such as corporations, church leaders, local "state's rights" warlords and the typical governing classes that conservatives throughout history have always preferred to government broadly responsive and accountable to the larger masses. Conservatives almost never talk about these alternative and competing power centers in their attacks on Big Government, yet their power over the individual can be just as great and often far less accountable than government, especially one based on consent of the governed.

riffing on comments in this great thread:

the rest of the developed world "rations" health care based on urgency and/or need....america does it by price.

there is two sets of citizens: the ones who think government is "us" and those who argue that government is "them."

"Twenty-seven percent of Canadians wait more than four months for treatment, versus only four percent of Americans. Twenty-four percent of Americans can't afford medical care at all, versus only 6 percent of Canadians. "

I'm sorry, but these two statements, together, make no sense at all.

24% of Americans can't afford health care at all, but only 4% have to wait for treatment?

How do the 20% of Americans who can NOT afford any health care at all avoid having to wait for it?

Don't the editors at the WaPo question their op-ed writers when the contradict themselves in two adjacent sentences?

Not to mention that PLENTY of Americans have to wait for treatment.

The Kraut Hammer must mean that of all those Americans who have health insurance that is GOOD enough to pay for treatment, who are seeking treatment their health insurance APPROVES of, who can afford their copays and deductibles, of that small slice of Americans, only 4% need to wait.

The U.S. presently spends about 17% of its GNP on health care, far more than any other country (in contrast the World Health Organization ranks our health care 34th best in the world). Are the Republicans seriously suggesting this should be increased to 100%? After all, anything less represents rationing.

Good point, Cal Gal: the figures for "how many people have to wait" must be, *the portion of those who go at all* - leaving out the ones who want to, but can't afford it. So the situation between US/Canada etc. is worse than it seems. This sort of un-/intentional statistical manipulation happens all over. For example, in telling us "people work fewer hours on average than they used to", the statistician has likely lumped FT and PT people together - but the FT people are working longer hours, there are just more PT added on.

24% of Americans can't afford health care at all, but only 4% have to wait for treatment? -- Cal Gal, @16:22

I think the way it makes sense is: 24% have no care at all. Of the remaining 76% who do, 4% have to wait as long as 4 months for a procedure. In essence, 72% of the population gets their (its?) healthcare delivered fast.

Here's a synopsis of Steve's post:

Charles Krauthammer: "I'm utterly clueless, but I'm in the Washington Post and on cable TV, so there!"

Ezra Klein: "Oh, yeah? Well, two can play at that game!"

David Leonardt: "Facts? You want facts? Hey, I gotcher facts for ya - right here!"

"Twenty-seven percent of Canadians wait more than four months for treatment, versus only four percent of Americans. Twenty-four percent of Americans can't afford medical care at all, versus only 6 percent of Canadians."

If 94% of Canadians have health care and 27% have to wait more than four months for treatment, then we can infer that 25% of all Canadians have to wait for treatment. That means the percent of Canadians who have to wait for treatment is approximately the same as the percentage of Americans (24%) who can't afford health care coverage at all. The same amount of "rationing" is happening in both the US and Canada. The difference is that at least in Canada you can hope to have the medical procedure eventually.

The thing I find interesting living in Canada as a US expat is precisely that health care is an openly political issue. How much to spend and where to spend it and on what to spend it is a subject over which people have a say, as opposed to the way it appears to US citizens--as some sort of accident of nature. I think this is another reason Canadians are proud of their system: they have a quasi-ownership interest in it.

If only we could pass a Constitutional Amendment denying Congress its taxpayer funded healthcare. Then we would get somewhere.

canada is in the top-10 in life expectancy...

usa is 50th..

what's rationed is charlies' cognitive function..

The National Academy of Sciences found that in America, at least 20,000 Americans die of treatable diseases every year simply because they can't see a doctor.

That's the harshest form of rationing.

In no other industrialized nation on the planet does someone die because they haven't received medical attention for a treatable disease.

More ways we ration, personal examples; My sister did the raesonable thing for people over 50, she had a colonoscopy. A benign polyp was removed. When she needed insurance, this was given as the reason she was denied.
Second example; In McHenry County Illinois (near Chicago) doctors have agreed that each will see only one medicaid patient each month.

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