Rationing

KG Smolderen and a multitude of the doctorly host report in the new JAMA that people who lack health insurance, or who are worried about out of pocket costs, delay longer before they show up at the hospital after a heart attack. Actually it's worse than that because they could only study the people who eventually made it there alive.

I would like to say, "Well duhhhh," but keep in mind that a favorite line of people who opposed the reform legislation was that we already do have universal health care when we really need it. Indeed, the greatest president of the 21st Century, the visionary whose portrait will one day be on the $3 bill, said "I mean, people have access to health care in America. After all, you just go to an emergency room."

Maybe so, but if they know it's going to cost them thousands, or tens of thousands of dollars, they are not inclined to do so. They'll hope it's just a bad case of indigestion. When people get there late, they are more likely to be rehospitalized, so it just ends up costing more in the end -- except of course for the people who have the good grace to just drop dead. Of course, the uninsured people are more likely to have a heart attack in the first place because their blood pressure and cholesterol are uncontrolled.

But we can't provide universal coverage because then we'll have rationing. Dumbasses.