"William Wixon" wrote in message
...

"Ed Huntress" wrote in message
...

-snip-


i saw something, i think it was pbs, just today, was about the flu,
doctors saying they can't use tamiflu on everyone because there's not
enough, they only use it for people most at risk (seems like rationing
to me). they were also saying if there was a virulent outbreak of flu
there wouldn't be enough respirators in the united states for everyone
and some people are gonna die because there just won't be enough
respirators. who gets to decide who's gonna get the available
respirators? there won't be any obama "death panels", yet, so who's
going to decide? insurance companies?

b.w.

That's who does it now. Doctors fight them all the time. Sometimes they
win. On the average, they lose.

From the discussions here I gather that not many people have run into
multiple life-threatening, expensive medical issues. I'm used to it, both
personally and because I was involved with it when I was doing medical
writing and editing.

I'm surprised at many of the questions and statements. Guys, they've been
rationing care for decades. It got going in a big way when HMOs came in.
It's the whole business of "Managed Care." For reference, I was the
Senior Medical Editor for Publicis Managed Care, a communications company
that served Big Pharma and that wrote to the managed care insurers.

Managed care is a euphemism for rationed care. That's what most of us
have now, whether it's through company PPOs or HMOs, or through
fee-for-service insurance. It's all the same in terms of insurance
companies dictating what procedures doctors and hospitals will be
compensated for. Doctors are involved in a constant struggle with those
insurers, submitting special appeals, getting on the phone with them, and
so on. That's life in the medical world today.

I can hardly believe anyone would bring up "rationing" as an issue today.
We're living in it. We have been for a long time.

--
Ed Huntress



well, so, i'm guessing insurance companies would say, if it was a kid, or
a working age adult, "give him the respirator", if it was a old person
they'd say "he doesn't get it". does anyone have an idea of who'd get a
respirator and who wouldn't? i'm guessing kids first, seniors last?

That would most likely be up to the doctors and their hospitals, and the
decisions would be made by a hospital ethics committee. The stock of
respirators probably is a budget issue for hospitals, and wouldn't be
something with which the insurance companies would get involved.

But it's another form of rationing. The hospitals, too, have to make
judgments about where to invest their money, based on actuarial analyses of
risks. It's another example that we already live in a rationed-care
environment.

i'm saying, now, not after obama's death panels start making decisions but
during this reign of the insurance companies. if there was a 1918 style
flu outbreak, who'd get the respirators first? wondering if race and
gender figure into it too.

b.w.

Check with a hospital. It's either them, or state oversight boards, who make
those decisions. Insurance companies are more likely to nix the use of an
expensive procedure or medication, where the question of benefits comes into
play.

That's the basic set of questions involved in all rationing.

--
Ed Huntress