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COVID-19-Induced Health Care Rationing a Preview of Medicare for All

The media have recently been carrying stories about rationing health care equipment, such as ventilators and personal protective equipment. It’s not a topic the U.S. health care system faces that often; but it’s part of life—and death—in government-run health care systems.
“State governments are facing a raft of complaints under federal law from a series of advocacy groups claiming that plans to possibly ration ventilators are discriminatory,” according to the Wall Street Journal’s Stephanie Armour.
Federal laws prohibit discrimination based on race, color, national origin, age, sex or disability. And yet, “Such discrimination complaints have been filed against Alabama, Kansas, Tennessee and Washington state, asserting rationing proposals are discriminatory,” according to the story.
But rationing based on age or disabilities is widely accepted, even embraced, among medical ethicists.
Dr. Ezekiel J. Emanuel, a well-known medical ethicist and brother of Rahm Emanuel, writing with a number of others in the New England Journal of Medicine, says,  “In the context of a pandemic, the value of maximizing benefits is most important.… Saving more lives and more years of life is a consensus value across expert reports.”
Franklin G. Miller, a professor of medical ethics in medicine at Weill Cornell Medical College, published an article for the Hastings Center entitled, “Why I Support Age-Related Rationing for Covid-19 Patients.” He proposes drawing the ventilator-access line at age 80 if resources are squeezed. He adds, “It seems fair to say that people who have reached that milestone have enjoyed an opportunity to live a complete life.”  
Aren’t you glad someone feels competent to decide when you’ve lived long enough?
If resources are still strained, then he proposes age 70.
Many medical ethicists generally agree on the utilitarian approach of “maximizing benefits.” And they have had years to come to that conclusion because government-run health care systems regularly face rationing issues—because health care becomes just one of many claims on government funds. Welfare, health care, education, social security, defense, national security—all compete for as much government money as they can get. Political compromises must be made and no agency gets all the money it wants—or needs.
Importantly, that’s why government-run health care systems spend much less than the United States on health care.

Former Democratic presidential candidate Bernie Sanders implies those systems spend less because they are so efficient. That’s ludicrous. It’s because politicians cap how much the government will spend on health care.
The result is that care is rationed for seniors and marginal patients with serious disabilities who may have poor prognoses.
To be clear, our purpose here is not to challenge whatever standards are being used in making health care rationing decisions. Someone has to decide who gets care when demand exceeds supply.
Our point is only that if the country embraces a government-run health care system like Medicare for All, rationing decisions will become the rule rather than the exception.