Yes, I do. There is certainly evidence that coverage is being withheld sometimes by insurance companies, and certainly people who can’t afford coverage aren’t getting it, but neither of those is ‘rationing’ by any commonly understood meaning of the word. Rationing takes place when resources are limited and the entity doing the rationing decides that beneficiaries are only entitled to a certain amount of what’s being rationed in an attempt to allocate those resources equitably or sparingly. And that is what the government UHC will have to do once it reaches the point that demand for health care exceeds its ability to pay for it.
It’s usually the case at this point in the discussion that Canada and Europe are brought up as evidence that this will not happen, but those countries haven’t been at government health care all that long themselves; nor do most of them have cradle-to-grave, 100% government-paid healthcare (which, let’s face it, is what most UHC proponents here in the U.S. want). And every one of them I’m aware of have lengthy wait times, which is a form of rationing in itself.
There’s no comparison. Medicare covers a relatively small percentage of the population that is in the latter stage of life (i.e., people who only need coverage for a decade or so, if that). It’s a horse of a completely different color entirely than a program that would seek to cover the entire population from cradle to grave.
And Medicare as it is now is no great shakes itself. A great many excellent doctors won’t accept Medicare patients because of low fees, bureaucratic red tape, and restrictions on the tests and care they’re allowed to order or provide. Plus much of it still has to be paid for by its beneficiaries, most of whom are on Social Security and barely making it already and who still have to pay $100 or so out of their roughly $900 or so monthly income just to have coverage. And then there are still deductibles and copays and so forth. The only thing good about Medicare is that it’s better than nothing.
And now a personal anecdote that illustrates perfectly one of my greatest fears when it comes to having the government in charge of people’s health care, which is that the individual patient has no control at all over what care he gets or when he gets it. Last year my former brother in law fell and badly injured one of his hip joints. He is in a lot of pain and has to swing his leg in a very exaggerated way when he walks in order to be able to move at all. He has a lot of trouble sitting, as well.
He was unemployed at the time and had no insurance, and thus he qualified for hip replacement to be paid for by the state I live in. When he was told last spring that he qualified for hip replacement surgery he was told that he was #59 on the list for that surgery. He called a couple of weeks ago and was told that he is now #159 on the list for hip replacement surgery. He asked what was the deal; he had been told all summer that he was #58 and now all of a sudden over the course of one month he was now at #159. The person he talked to said something along the line of “Well, all I can tell you is that now you’re number 159”, and of course he has no recourse but to suffer and wait until whenever he finally able to get his surgery.
Now, it’s true that he’s still better off than if he’d had no way of getting treatment at all, but it’s also true – if the experiences of my family members and acquaintances are to be believed – that if he’d been employed and covered by insurance he would have had his surgery months ago and probably within days or weeks after he’d injured himself.
So yeah, I don’t want to live in a country where everyone has to go begging hat in hand to the government for treatment to ease their pain and suffering, and being told, in effect, “Tough shit, you’ll get it whenever we get around to it, and we have no way of knowing when we’ll get around to it”.
Most of the people in this country have perfectly good coverage, and to the extent that insurance companies are operating fraudulently or dishonestly, laws should be passed that crack down on them and put a stop to it. And some dispensation needs to be made for people who have no coverage but are in dire need of care. But bringing everyone under the umbrella of an uncaring and chronically underfunded government bureaucracy to provide for their health care will result in the vast majority of its citizens receiving care that is nothing less than atrocious compared to what they have now.