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We’re All Rationers

Certainly telling seniors to buy all their own health care is a complete political (and ethical) non-starter. But telling seniors to pay for more of their own health care — well, it’s hard to see how else we can hope to reduce Medicare’s fiscal burden. Maybe the premium support/voucher model that the Ryan budget proposes isn’t the optimal way to do it. But every other mechanism for serious cost containment leads inexorably to a similar place.

This is obvious when you think seriously about the main Obama administration proposal for Medicare reform — the famous IPAB plan, which would put a board of experts in charge of deciding which treatments Medicare will and won’t cover. If it had any deficit-cutting teeth at all, such a board would constantly end up asking seniors to pay for their own health care (or else go without it), by refusing to pay for treatments that doctors would otherwise prescribe.

From We’re All Rationers

Mr Douthat is right here. There is no form of cost control that is not also a form of rationing. Anyone that is pro-cost-control but anti-rationing doesn’t understand the problem.