I believe a nation does not maximize its health care until it starts to ask the hard question: How can we prioritize our expenditures to buy the most health care for the most people? We should not apologize for rationing; we should promote it and advance it.
We implicitly or explicitly ration health care no matter what we do.
I believe for some high-technology medicine, like transplants and kidney dialysis, age should be a consideration in the delivery of that technology. In a world of limited resources, we have a larger duty to a 10-year-old than to a 90-year-old.
Although I believe deeply that the Children's Health Insurance Program and the Community Health Center program are invaluable, I reject the notion that we cannot reauthorize these programs without plundering other equally vital programs.
The decision is not whether or not we will ration care. The decision will be whether we ration care with our eyes open.
Let's take care of mothers and infants first, and then let's see what's left over for everybody over 50. I'm over 50. If I get sick, I would rather have money spent on children before it's spent on me.
Now, decisions with a major impact on health care are made in conjunction with budgetary decisions. Before we debated health policy. Now we debate fiscal policy.
It is inevitable that we are going to have to ration health care in the United States.
Not reforming the NHS would have been a much easier decision for me as secretary of state to have taken. We could have just protected the NHS from cuts, put in an extra £12.5bn and left it there. But sooner or later the cracks would have started to show. New treatments would have been held back.
