How Medicare Was Saved from Rationing-And Why It's Now in Danger.

Editor's note: Since its inception, the National Right to Life Committee has been equally concerned with protecting older people and people with disabilities from euthanasia as with protecting the unborn from abortion. We have recognized that involuntary denial of lifesaving medical treatment is a form of involuntary euthanasia, and therefore have opposed government rationing of health care. In 1997 and 2003, NRLC successfully fought to amend Medicare by allowing older people the right to use their own money to obtain unrationed care; shockingly, under the new leadership of Congress that right is now at risk. Here's the background:

Most people are aware that Medicarethe government program that provides health insurance to older people in the United Statesfaces grave fiscal problems as the baby boom generation ages.

Medicare is financed by payroll taxes, which means that those now working are paying for the health care of those now retired. As the baby boom generation moves from middle into old age, the proportion of the retired population will increase, while the proportion of the working population will decrease. The consequence is that the amount of money available for each Medicare beneficiary, when adjusted for health care inflation, will shrink.

Three alternatives exist. In theory, taxes could be increased dramatically to make up the shortfall. Few knowledgeable observers consider this likely, regardless of which party is in power in Washington.

The second alternativeto put it bluntly but accuratelyis rationing. Less money available per senior citizen would mean less treatment, including less of the treatments necessary to prevent death. For want of treatment, many people whose lives could have been saved by medical treatment will perish against their will.

The third alternative is that, as the government contribution decreases, the shortfall is made up by payments from older people themselves, so that their Medicare health insurance premium is financed partly by the government and partly from their own income and savings.

Although it goes against the conventional wisdom, there is reason to believe that on average Americans could afford to pay for this. (See "Why America Can Afford Unrationed Health Care," p. YY.)