So Conservatives Now (Heart) Rationing?

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America spends too much money on health care—this much Republicans and Democrats alike can agree on. Where they differ is on the best way to curb costs and unnecessary, inefficient care. In other words, somebody’s got to say “no” to unnecessary spending, and that’s not something that most Americans are going to want to hear. Democrats have been more willing to face this reality than their Republican counterparts. When the Dems introduced their own cost-controls in the Affordable Care Act—including research that would compare the effectiveness of different treatments, advice for end-of-life-counseling, and an independent board that would set payments for Medicare—the GOP attacked them for creating “death panels” and a Soviet-era bureaucracy to “ration” care.

That said, a growing number of conservatives have begun to admit that some form of rationing is necessary to prevent America’s health care system—and the economy as a whole—from self-destructing. “There’s no way out but rationing—either by making seniors pay much more for their healthcare or denying them much more than basic care,” writes Andrew Sullivan. Some Republicans are now casting Rep. Paul Ryan’s budget plan as a form of “self-rationing” that would place such decisions in the hands of private citizens, rather than cold-hearted bureaucrats. “Rationing is going to go on within the Medicare system. It’s a fact of life” given financial constraints, the Cato Institute’s Michael Tanner tells Politico. “The question’s going to be, is that decision going to be made by government and imposed top down under the current system? Ryan wants to shift that responsibility to individuals and from the bottom up.”

But far from creating a nation of empowered individuals free from government constraints, the Ryan plan will simply shift that authority to the private insurance industry. As NPR reports, the Congressional Budget Office says that insurers would have far greater leeway to do things like “limiting benefits, changing co-payment amounts, managing how patients use services” under RyanCare, free from ObamaCare’s consumer protections that prohibit exploitative practices. What’s more, private insurance is less cost-effective than government-run health care, forcing seniors to pay more and get less. 

So the elderly may be forced to use less health care under Ryan’s plan, and government spending on Medicare will go down. But rather than using scientific research and the consensus of experts to make more cost-effective Medicare choices, the Republicans will take a hatchet to Medicare costs and then hand the weapon over to private insurances. Rationing must happen, yes—but it can be done far more intelligently.

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

If you can, please support the reporting you get from Mother Jones—that exists to make a difference, not a profit—with a donation of any amount today. We need more donations than normal to come in from this specific blurb to help close our funding gap before it gets any bigger.

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