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Henry Aaron, PhD, Senior Fellow at The Brookings Institution, wrote in his Jan. 30, 2006 article titled "A Healthcare Prescription That's Hard to Swallow; Rationing May Be the Only Way to Ensure That Access for All Remains Affordable," published in Los Angeles Times Commentary:

“Seven U.S. workers in 10 still get health insurance coverage as a fringe benefit of employment. But perhaps not for long. Healthcare spending gobbled up nearly $2 trillion in 2004, and it has grown about 2 1/2 percentage points a year faster than income for decades…

The truth is that sensible rationing may be the only way to make sure that fair access to healthcare for all remains affordable. The U.S. can no longer afford to offer every available service no matter how high the cost or how small the benefit to the patient. Intelligent healthcare rationing — limiting the availability of care that costs society more to produce than it is worth to patients — is not a horror to be avoided. It’s a regretfully necessary limit to sustain fair access to healthcare that is worth what it costs.

To see the connection between rationing and affordable care for all, one must recognize that insured patients pay little of the cost of their own care when ill. So they quite understandably want everything that might conceivably add even some tiny benefit — the extra test that provides hardly any information at all, the surgery that is little or no better than watchful waiting, or the costly patented drug that is little or no better than the inexpensive generic…

At current trends, [healthcare] will require more than one-third of the nation’s output by 2030. This means we would have to double both income and payroll taxes just to maintain current levels of healthcare for the elderly, disabled and poor. Unless we squeeze out services that are worth less than they cost — in other words, unless we ration — even cost-effective care will become unaffordable…

Failure to ration, however, will mean that the cost of caring for the aged, disabled and poor will require astronomical tax increases — and that working Americans will have less money to spend on anything other than healthcare. Employers will find it increasingly unattractive to sponsor coverage for workers, and workers will refuse increasingly costly coverage. What Winston Churchill said of democracy may also apply to healthcare rationing: the worst system — except for all the others.”

Jan. 30, 2006