Obama rule will reform health care by allowing you less of it.
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In our fragmented health-care system, only the federal government is in a position to develop national quality standards that everyone would follow — and it would cost relatively little for it to do so. In Great Britain, the National Institute on Clinical Excellence (NICE), which develops guidelines for the National Health Service (NHS), spends less than 1% a year of its total national health spending.
Indeed, NICE is so nice that in 2006, as Betsy McCaughey reports at Bloomberg.com, it “decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye.” This was not an isolated policy decision. As McCaughey further reports, NICE “approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit.” This leaves senior citizens at a great disadvantage, because they have fewer years left to enjoy the benefits of any medical treatment. As a result, McCaughey continues, “Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.” Do you see the fascism yet?
Yet, Daschle holds up this bureaucratic nightmare as a model for the U.S. Indeed, Daschle proposes the creation of a Federal Health Board to run the U.S. health care system explicitly modeled after this U.K. bureaucracy that mercilessly rations health care for the British people. Daschle writes:
In other countries, national health boards have helped ensure quality and rein in costs in the face of these challenges. In Great Britain,…NICE…is the single entity responsible for providing guidance on the use of new and existing drugs, treatments, and procedures….NICE also weighs what it calls ‘economic evidence,’ or how well the medicine or treatment works in relation to how much it costs.
This is what is meant by “government run health care.” You don’t want a remote, far away, centralized, national health bureaucracy making decisions about what health care is right for you, what medical services and treatments will be right for you, what latest, most advanced, medical technologies and treatments will be available for you. You want doctors and patients making those decisions. Big government bureaucracies can never have all the information about you and your health that you and your doctor have, and they don’t have the same interest in you and your family that you have. You don’t want such government bureaucracies in control of your health care. You want to be in control of your own health care.
Nevertheless, such government run health care is exactly what Daschle proposes, as favored by Obama:
The Federal Health Board would promote “high value” medical care by recommending coverage of those drugs and procedures backed by solid evidence. It would exert influence by ranking services and therapies by their health cost impacts….We won’t be able to make a significant dent in health care spending without getting into the nitty-gritty of which treatments are the most clinically valuable and cost effective. That means taking a harder look at the real costs and benefits of new drugs and procedures. In Great Britain, NICE…uses cost effectiveness information in deciding whether to cover a new drug or procedure….The challenge…is creating an entity with the credibility and the clout to make those tough decisions. (Emphasis added.)
A centralized, Big Government bureaucracy doesn’t know “which treatments are the most clinically valuable and cost effective,” and doesn’t even have the right incentives to find out in a timely manner. In country after country where such systems have been established, the interests of truly sick patients have been routinely sacrificed on the alter of the government’s short term political interests in serving the far more numerous and politically active healthy patients, and keeping their costs down. Yet Daschle touts the health rationing bureaucracies of these countries as well as models for the U.S.
McCaughey explains what is really going on here:
In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make. The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research….The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forego experimental treatments,” and he chastises Americans for expecting too much from the health care system. Daschle says health care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.
Indeed, Daschle confesses in his book that “Medicare could pay more for operations that are recommended, and less for procedures and drugs that seem discretionary,” according to the Federal Health Board. That Board could also “link the tax exclusion for health insurance to insurance that complies with the Board’s recommendations.” Daschle concludes, “If the Federal Health Board fulfills its mission, it will have to reduce or deny payment for new drugs and procedures that aren’t as effective as current ones.”
Canada is another country with a national health care rationing system similar to Great Britain’s. In a recent article in the Wall Street Journal, Nadeem Esmail, Director of Health System Performance Studies at the Fraser Institute in Canada, provides some examples of experience under that system:
In Ontario, Lindsay McCreith was suffering from headaches and seizures yet faced a four and a half month wait for an MRI scan….He went south, and paid for an MRI scan across the border in Buffalo. The MRI revealed a malignant brain tumor. Ontario’s government system still refused to provide timely treatment, offering instead a months long wait for surgery. In the end, McCreith returned to Buffalo and paid for surgery that may have saved his life.
Esmail offers another example:
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