Health-care costs bankrupting us

Sen. Mitch McConnell says that determining medical treatments is "a decision we currently leave between a patient and his or her doctor. And that's where it should remain."

This pronouncement will astound many Americans who know all too well that an insurance company also decides what medical treatments they'll get.

How could McConnell be so naive? A couple of explanations spring to mind:

1. The government health insurance he receives as a member of Congress provides such generous and comprehensive coverage that he doesn't have to worry.

2. He'll say anything to try to derail President Barack Obama's record of success in Congress.

McConnell and other Republicans are playing on fears of health-care rationing, which they warn is a likely dire consequence of the reform plans making their way through committee.

The reality is that health care is already rationed in this country, just not on any rational or humane basis.

If you have a pre-existing condition, for example, you're rationed out of being able to buy affordable coverage or perhaps any health insurance at all. If you're self-employed, you'll have a hard time affording coverage.

And sometimes even if you have health insurance, it won't pay for the care you need. Most personal bankruptcies are because someone got sick or injured.

The Journal of American Medicine reports that Harvard researchers discovered that health problems caused 62 percent of personal bankruptcies in the U.S. in 2007.

Only eight percent of the medical bankruptcies were because the person could not return to work. The vast majority were because they could not pay the medical bills.

Three-fourths of those bankrupted by medical problems had health insurance when they took ill, including 60 percent who had private coverage, not Medicare or Medicaid.

It hasn't always been like that. In 1981, only eight percent of families filing for bankruptcy cited a medical problem as the cause.

This downward spiral is burying not just families but the entire economy under uncontrolled health-care costs.

McConnell was quoted by National Public Radio Tuesday in a report on "comparative effectiveness" research. These are side-by-side studies of which medical treatments work best.

The bill that's moving through the House creates a center for such research and a commission to oversee it but stops short of saying the findings should be used to cut health-care costs.

McConnell warns against letting "government bureaucrats" use research to decide what treatments Americans can get.

But one of the experts quoted by NPR pointed out that health care is one business in which it's possible to be both inefficient and highly profitable, so there's little market-based incentive for change.

Maybe the real choice is: Would we rather have our health-care decisions based on what's best for an insurance company or what's proven to be most effective?