Richard Lamm, director of the Institute for Public Policy Studies at the University of Denver has just published “The Brave New World of Health Care,” in which he argues that widespread rationing is inevitable within the next 20 years.

Otherwise, Lamm warns, health care will become a fiscal black hole that will consume our children’s future. As he sees it, “The health care system is consuming massive resources that are desperately needed in other parts of the economy if we are to leave our children a sustainable society.”

His book proposes six essential reforms:

* Provide access for all to a base level of health care.

* Develop a means of limiting the use of procedures that are ineffective or marginally effective, or that are effective but too expensive.

* Develop a consensus on social and individual health care priorities.

* Place limitations on malpractice suits.

* Control the health care bureaucracy.

* Place limitations on the supply side of health care.

Implementation of these suggested reforms, especially developing a consensus on priorities, is going to be difficult and may prove impossible, but limitation or rationing, is inevitable. The only question is will we address it deliberately and clearly, or will we slip into it in a blind and haphazard way?

The House recently debated a bill (L.D. 882) that brings Maine’s health care mandates in line with those required by the Affordable Health Care Act. Maine currently has many more mandates than even this 2.000-plus page bill requires. If these mandates remain in place, when the act is fully implemented, Maine’s private insurance rates could rise 38 percent, according to the recent Gorman Actuarial study.

During the debate, I argued that multiplying Maine’s mandates beyond our ability to cover the cost runs against simple common sense. Among other things, I ridiculed the idea that my 20-year-old son should be required to buy health insurance mandating Pap smears. As a result, I have been named generalissimo of the Republican “War on Women.”

This is not a women’s issue. The issue is whether we are willing to face the facts that unlimited, unrestricted health care is not, never has been and never will be an option. Say that you can’t put a price tag on a person’s life and most people will agree. This is a nice sentiment, but it’s a fantasy that has no place in the real world. Health care always runs into limits. Governments either ration it (a limit and burden on the patients) or impose price controls (a limit and burden on the care-givers).

Private citizens confront the same reality. If old age ever brings me to the point where my children have the choice of prolonging my life in a coma for another six months at the cost of their homes, their savings and their credit, I hope and expect they will have the sense to tell the doctors to pull the plug. I believe that almost everyone would do the same, given the choices. That may be a cold thing to say, but reality is often cold.

I know some people will think less of me for saying these things. My only answer is that I did not invent reality. It’s not my responsibility. It existed before I was born and will continue after I die.

Anyone objecting has to argue that yes, governments are willing to use up all their revenues on health care and yes, that average families are ready to bankrupt themselves to prolong the fading lives of their members for a few months.

Our declining birth rates mean that excessive mandates to insurance plans will disproportionately force the cost ever downward to the young; leaving them with the choice of spending most of their working lives paying for continuously growing health insurance coverage, much for which they have no use, or going without.

Unfortunately this is the current situation in Maine.

The bill debated sought to offer some choice to those under the heavy yoke of Maine’s burdensome insurance mandates.

Rep. Lance Harvell is a Republican representing the towns of Farmington and Industry.


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