At the White House's health care town hall on Wednesday, an epilepsy specialist named Orrin Devinsky asked a question that haunts proponents of reform:
"President Obama, if your wife or your daughter became seriously ill, and things were not going well, and the plan physicians told you they were doing everything that reasonably could be done, and you sought out opinions from some medical leaders and major centers, and they said there's another option that you should—should pursue, but it was not covered in the plan, would you potentially sacrifice the health of your family for the greater good of insuring millions? Or would you do everything you possibly could as a father and husband to get the best health care and outcome for your family?"
That question—the health care equivalent of asking Michael Dukakis whether he would still oppose the death penalty if his wife were raped and murdered—lays out a disturbing scenario. Fortunately—for the White House as much as for anyone with a sick spouse or child—it's not very realistic.
The logic behind the question is clear enough. It's easy to talk about cost cutting in macro terms: As much as 30 percent of health care spending goes to unnecessary treatments. Eliminate those, and we're good. But on an individual level, who defines "unnecessary"? Who is going to decide not to order the extra test or the extra treatment? When it's your life or your child's at stake, are you really going to turn down a long-shot treatment just because it's too expensive?
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