Thursday, May 17, 2012


The ongoing debate over Obamacare has brought to light the concept of rationed healthcare. Opponents of health care reform keenly point out that while the bill never explicitly calls out rationing, it features certain provisions that will lead the markets to adjust to strict federal demands and, therefore, dispense certain procedures in smaller amounts or not at all. Because of it being the first time that the subject has really come up in public circles, most people, especially on the right, believe that rationing is something new. It’s not. The free markets have been practicing that for quite some time. I should know; with a 4-inch long, 1-inch wide scar running south of my belly button – and a couple of related scars around my groin – I could be the poster child for rationed health care.

In 1997 I went to the emergency room after suffering with incredible pain near my stomach. The old-fashioned tests and the white blood cell count told the doctor it was appendicitis. He said that in the old days he would have taken out the offending body part, but he couldn’t now as he was hamstrung by the insurance companies which indicated the WBC count was in “the grey area.” So, he let me go and said the appendix would flare up again and, at that time, they would operate.

He was right. Nearly 2 years later it acted up on a Friday night. But, I let it go for the whole weekend thinking it was food poisoning. By Sunday afternoon the useless organ exploded and only painful urination (the result of the infectious poison surging through my body) sent me to the ER. After 18 hours of waiting and testing in the hospital, it was determined that I had peritonitis. I was rushed into emergency surgery and spent a week in the hospital. I lost 30 pounds and nearly my life.

That begs the question: What did the health insurance provider lose? In 1997, had the appendix been attended to as it would have been traditionally, It would have been a simple, relatively inexpensive procedure. Instead, they had to blow tens of thousands of dollars on elaborate surgery and post-operative care -- while putting me at risk -- because of the initial attempt at rationing.

I’m not the only one who has suffered at the hands of the HMOs in regard to the strict, often ridiculous, dispersal of care. Various other maladies fall under similar limitation clauses, while some insurance companies have caps on payments for specific services or participate in dumping of the insured. It’s a system that threatens the well-being of millions of Americans.

Things won’t get any better with Obamacare, which offers the public sector bedfellow for the private sector’s devious practice. It’s nowhere near as hideous as the overblown “Death Panel” hysteria once driven by Sarah Palin, but it’s dirty nonetheless through 3 entities it has empowered. The advent of Affordable Care Organizations will reward doctors for keeping costs under control. The Patient-Centered Outcomes Research Institute will create templates for what constitutes worthwhile investments in health by private and public providers. The Independent Payment Advisory Board will limit payments to doctors, hospitals, and health care providers, forcing their hand in deciding what to offer.

There’s no doubt that health insurance and Medicare are too expensive and will become even more so (the cost of insurance to my company and coworkers grew by 112% over the past 9 years). But, hare-brained rationing schemes aren’t fully effective in tempering costs, and hot tempers caused by one side blaming the other for doing something its side is guilty of is not good for advancing an appropriate discussion of health care in America. Rather than rationing care by policy alone (and not the situation that presents itself), we’re better off finding significant savings elsewhere through self responsibility, the elimination of state borders in health shopping, the creation of true (risk-based) health insurance and the destruction of the HMO system as we know it. But, those are issues for another day…and another column.

Bob Confer is a Gasport resident and vice president of Confer Plastics Inc. in North Tonawanda. E-mail him at


This column originally ran in the 21 May 2012 Greater Niagara Newspapers

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