How Washington rations

The editorial page of the Wall Street Journal is ramping up its opposition to President Obama's plan for universal health insurance coverage. It's not because members of the paper's editorial board don't want people to have access to good health care - it's because they do.

The WSJ says the evidence of what is likely to happen if the Obama/Congressional Democrats' plan is adopted is staring us in the face.

[A new "universal" health insurance entitlement for the middle class] will have drastic effects on the health care of all Americans - and as it happens, this future is playing out in miniature in Medicare right now. Desperate to prevent medical costs from engulfing the federal budget, the [Medicare] program's central planners decided last week to deny payment for a new version of one of life's most unpleasant routine procedures, the colonoscopy. This is a preview of how health care will be rationed when Democrats get their way.At issue are "virtual colonoscopies," or CT scans of the abdomen. Colon cancer is the second leading cause of U.S. cancer death but one of the most preventable. Found early, the cure rate is 93%, but only 8% at later stages. Virtual colonoscopies are likely to boost screenings because they are quicker, more comfortable and significantly cheaper than the standard "optical" procedure, which involves anesthesia and threading an endoscope through the lower intestine.

Virtual colonoscopies are endorsed by the American Cancer Society and covered by a growing number of private insurers including Cigna and UnitedHealthcare. The problem for Medicare is that if cancerous lesions are found using a scan, then patients must follow up with a traditional colonoscopy anyway. Costs would be lower if everyone simply took the invasive route, where doctors can remove polyps on the spot. As Medicare noted in its ruling, "If there is a relatively high referral rate [for traditional colonoscopy], the utility of an intermediate test such as CT colonography is limited." In other words, duplication would be too pricey....

[So] Medicare...made the hard-and-fast choice that it was cheaper to [rule out such procedures] for all beneficiaries....

[The health insurance plan that] Democrats favor...would transfer millions of patients to a new insurance program managed by the federal government. [And] Washington's utilitarian judgments about costs would reshape the practice of medicine....

Anyone who buys Democratic claims about "choice" and "affordability" will be in for a very rude awakening."

Sometimes it is appropriate for hope to triumph over experience. But with the stakes this high - literally the reshaping of the health care delivery system - do we really want now to be one of those times?

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Joseph Slife is a contributing author and editor for SMI. Visit www.soundmindinvesting.com to learn more.