Republicans Like Rationing, the Dumb Kind

by Jonathan Cohn | March 11, 2011

Need more proof that the Republican Party is not ready to govern seriously? Listen to what Mike Huckabee is saying about "comparative effectiveness research."

CER, as it's known, is the study of which medical treatments work better than others. When you describe it that way, it probably sounds uncontroversial. That's because it is--or, at least, it used to be, back in the day when even Republicans recognized that we shouldn't be spending so much money on drugs, devices, and procedures that don't actually make people better than existing treatments. 

But Republicans and their allies in the conservative movement no longer say such things. Instead, they say that government will use CER to deny people beneficial treatments--that it is, as Huckabee puts it, "the poisonous tree of which death panels will grow." 

Ezra Klein captures the situation nicely:

at the moment, the Republican Party’s position is that Medicare and Medicaid cannot use studies measuring the effectiveness of different medical treatments when deciding what to cover or not cover. Another way to say that is they’ve decided against saving money by making better decisions about what to buy. Their remaining options are to save money by paying doctors and hospitals less than things currently cost, or to save money by giving seniors and Medicaid recipients less than they currently need. With smart rationing off the table, dumb rationing is all we have left.

I'd actually go farther and suggest that Republicans have a clear preference among these two forms of "dumb rationing." For the most part, Republicans don't want Medicare paying less to the providers and producers of medical care, whether its drug companies, hospitals, or doctors. That's excessive government interference in the market or, worse, outright control of prices. That leaves just one method for reducing the cost of Medicare: Reducing the size of the insurance package itself, ideally by turning the program into a voucher whose value will steadily decline over time.

Source URL: http://www.newrepublic.com//blog/jonathan-cohn/85105/republicans-rationing-the-dumb-kind