Former Governor Dick Lamm has come out to do something that most of us realists in the healthcare debate have done long ago: acknowledged that the “r-word”–rationing–is not a dirty word, and in fact, is something we already do in our health care system. Moreover, rationing is not something to fear as a result of any public healthcare option we would embrace as part of “Obamacare”, but in fact rationing is a real part of the healthcare system we exist in each and every day. We simply accept it as part of a system that we fear changing and it is that stubbornness that will be our downfall.

In his commentary on the Huffington Post blog, Lamm makes the point clear and simple:

“The United States now has the worst form of rationing. We ration people by leaving them out of the system. We tell each other that this is indirect rationing, and apparently we find this morally easier to accept than direct rationing. A sin of omission is easier to live with than a sin of commission. But it is rationing in its cruelest form: the Institute of Medicine estimates that 20,000 Americans die each and every year simply because they lack health coverage.”

So rather than steering clear of the r-word, Lamm calls a spade a spade and says that it’s time to stop the very worst kinds of rationing–the morally unacceptable, indirect kinds that leaves people uninsured and out in the cold, and to explicitly ration where we can and must using whatever resources we have available.

I couldn’t agree more. We are long past due to stop thinking of rationing as a dirty word. We already do it–indirectly and with disastrous results. If we did it explicitly, the outcomes are certain to be better.

Summer Johnson, PhD