Think of it. An alliance between Freddy Krueger, Michael Myers and Norman Bates, three of the scariest characters in horror moviedom. Stars of, respectively, A Nightmare on Elm Street, Halloween, and the Alfred Hitchcock classic Psycho, these guys all have three specialties. They jump out at you when least expected. They think of themselves as omniscient. And most importantly they keep coming back. And back. And back.
Come on now, admit it. The first person you’d go to for a consultation if you were diagnosed with cancer is the Freddy Krueger of the piece, that renowned international cancer specialist Dr. Pete Stark. Oh, sorry. Make that Congressman Pete Stark. Come to think of it, before he was a California Congressman, before he was apologizing on the House floor for his recent suggestion that the President of the United States sends American kids to die in Iraq just for “amusement,” Stark was not a physician at all but a millionaire banker.
Be that as it may, Freddy, I mean Dr. Starkâ€¦sorryâ€¦Banker Stark is now the chairman of the House Ways and Means Subcommittee on Health. Which makes him (but of course!) a physician in his own mind.
This would be humorous if the subject were not so serious. And make no mistake, it is deadly serious for cancer patients all over America. It’s also a story that illustrates with a particular clarity the danger that looms in the notion that your health care should be entrusted to government bureaucrats and politicians instead of your doctor.
At issue in this Washington version of a horror film is a July 30, 2007 “National Coverage Decision” a policy pronouncement by the third player in this drama, the Bates Motel of the piece otherwise known as the government Centers for Medicare and Medicaid Services, or CMS. The CMS, populated by an army of bureaucratic Norman Bates’s, has decided that it will restrict the use of a drug called Erythropoiesis Stimulating Agents (ESAs) under Medicare. In plain English, this is a drug that is provided cancer patients taking chemotherapy. Chemotherapy, of course, is designed to kill cancer cells. When it does so it has the unfortunate — and dangerous — side effect of killing good cells, including those that manufacture red blood cells. Without enough red cells, the patient becomes anemic, which in turn could force the end of the chemotherapy and the potential return of the cancer. The existence of ESAs, which contain the protein that stimulates the production of red blood cells, now permits patients to continue their chemotherapy while treating the anemia and eliminating the need for blood transfusions.
Sounds like a doctor-patient discussion to me and probably to you too.
Alas, Freddy…Dr. Stark…sorry, Banker Stark…disagrees. So too does his sidekick in this Washington Halloween story, the Michael Myers of the tale, the Banker’s California colleague Henry Waxman. Waxman, you will be shocked to learn, is not a cancer specialist either but rather a Beverly Hills lawyer. (American Spectator readers will remember that Waxman was last the subject of a story in these precincts revealing his determination to use his congressional power as chairman of the House Oversight Committee to decide what you can and cannot listen to on talk radio. Once publicized, Waxman denied the charge, although the facts in the story remain un-refuted.)
SPECIFICALLY, BANKER STARK and Lawyer Waxman have combined in a seriously scary Congressional combination as they consult with the Norman Bates Bureaucrats, the proprietors of Bates Motel, aka CMS. Under the circumstances, the fictional Freddie Krueger and Michael Myers are decidedly less scary than the real life Banker Stark and Lawyer Waxman. After all, the first two, however vivid, are celluloid creatures. The Banker and the Lawyer are seriously powerful real people who want to substitute their own judgment and that of the bureaucrats at CMS for the opinions of a cancer patient’s doctor as to extent of the use of ESAs under Medicare.
What does this mean for you? If you are covered by Medicare and you need this treatment, the Banker and the Lawyer agree that the Bureaucrat should blow off the fervently expressed concerns of the cancer specialists, in this case those of the cancer specialist doctors of the American Society of Clinical Oncologists and the American Society of Hematology. They, the Banker, the Lawyer and the Bureaucrats — not you and your doctor, thank you very much — will make the decision on whether you need this cancer treatment. Or not.
In fairness to the Banker and the Lawyer I should say specifically why they believe you and your doctor must be relieved of deciding the details of your medical care. They are afraid that doctors, egged on by the makers of the drug, will overuse the drug just so they can steal the Bureaucrat blind. This would be called Medicare fraud.
Let’s stop the Halloween tale here for a moment. On the eve of what will undoubtedly be a momentous election campaign in which health care will be a major issue, it’s important to note the two major underlying assumptions that divide the Banker, the Lawyer and the Bureaucrats from so many of the rest of us. Not only on the issue of health care but a whole host of other issues as well.
THE FIRST ISSUE IS capitalism. They don’t like it. The second issue is big government bureaucracies. They are crazy in love with those.
The first underlying assumption in turn makes the enemy in the Stark-Waxman narrative of this cancer medication case the makers of the ESAs. The drug companies. The capitalists. By name in this case the capitalists are Amgen (which is actually a biotech company) and Johnson & Johnson. The world view of the Banker Stark and Lawyer Waxman religiously insists capitalists are shady guys at best, seriously evil guys at worst. They are, to quote an obviously disturbed Stark on Amgen, “profit driven.” How does this translate in this situation? It means Banker Stark and Lawyer Waxman look at Amgen employees, for example, and see almost 18,000 Gordon Gekko’s, the slicked-haired, “greed is good” villain of Oliver Stone’s movie Wall Street, instead of 18,000 dedicated men and women working their tails off to come up with innovative advances in medicine. The Amgen folks, while a global company, have the bulk of those 18,000 employees right here in America. One does not need to know a single Amgen employee to understand that a crowd of 18,000 would include men and women who are husbands, wives, mothers, fathers, single parents busy parenting kids, and so on. They pay mortgages, buy groceries and, at least in America, they pay lots of federal (and other) taxes as well. Taxes that, yes indeed, pay for the upkeep of congressional salaries, lifestyles and those endless committee hearings and Waxman investigations overpopulated with well-fed staff with too much time on their hands.
So too do the Banker and his Lawyer sidekick view the doctors in this equation with barely disguised disdain. The men and women in the medical field that all of us have encountered in a life, the men and women who work incredible hours and have, in overwhelming numbers, assisted ourselves or family and friends in hours of medical need are, to the Banker and the Lawyer, a caricature of something else altogether. In the Stark-Waxman narrative cancer specialists are played as the Gordon Gekko’s of medicine, slick seekers of ways to violate the Hippocratic oath and deliberately mistreat patients because they are in league with the evil drug makers. You know, gotta rip off the government and sell the meds to keep up those country club dues.
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