WASHINGTON — If you have any sense that you may be getting sick
in the years ahead, I suggest you get sick immediately. If you
will be in need of surgery or any other medical procedure, do it
now! If not immediately, be certain that you hand yourself over
to the healthcare professionals before October 15 of this year.
That is the date on which President Barack Obama hopes to sign
his healthcare bill once it has gone through the congressional
baloney grinder.
At the heart of President Obama’s plan is his stated goal to cut
medical costs. That might sound good to you, but it means cutting
services, nurses, technicians, medical tests, and most
prominently the use of expensive technology. The President’s top
medical advisers are quite frank about this. Dr. Ezekiel Emanuel,
brother of Rahm Emanuel and a health policy adviser in the Office
of Management and Budget, has chided Americans for the expense of
their “being enamored with technology.” Dr. David Blumenthal,
another key Obama adviser, charges medical innovations as being
responsible for fully two-thirds of the annual increase in
healthcare spending. Their solution is to limit expensive
innovations. A 2008 Congressional Budget Office report agrees
with their cost analysis but concludes happily that such
innovations “permit the treatment of previously untreatable
conditions.” As I shall show, there are more humane ways to cut
healthcare costs.
Also at the heart of President Obama’s plan is the restriction of
services for older people, people 65 and older who by virtue of
modern medicine may actually be ten and fifteen years younger in
terms of good health than they would have been a generation ago.
Alas, they still have higher health risks and costs than younger
people. Thus they are going to bear the brunt of the Obama
Administration’s cost cuts, for 27-30% of Medicaid spending is
spent for caring for people at the end of their lives. With the
government taking over more of the nation’s healthcare costs
under the Obama regime, it has already been decided that
government monies are more economically spent on younger people
than on older people. If a 65-year-old needs a hip replacement,
the government will better spend that money on a younger person
whose hip will last longer. Or perhaps the government will decide
the money is better spent on preventive medicine for younger
people.
In the federal stimulus legislation that the president signed
February 17, we find funding for a Federal Council on Comparative
Effectiveness Research. “Comparative effectiveness research” is a
term used by economists in healthcare for making health
comparisons based often on age and for limiting care based on a
patient’s age. In Great Britain comparative effectiveness
research is actually used to deny patients treatment for
age-related diseases such as heart disease and macular
degeneration. When the federal stimulus bill was going through
Congress there were warnings regarding the consequences of
comparative effectiveness research. Rep. Charles Boustany Jr., a
heart surgeon, warned that it would lead to “denying seniors and
the disabled lifesaving care.”
Yet the policy remained in the bill along with requirements for
doctors’ offices and hospitals to maintain data banks on patients
while creating a national network to monitor patients’ care. The
good side of that is that a central data base can send out the
latest information on treatments, though doctors who keep up with
their medical journals already know about these treatments. The
dark side is that it will allow the federal government to control
how our doctors treat us. The bill speaks of “appropriate” and
“cost-effective” care and provides penalties against doctors
beginning in 2014. Now there is an Orwellian twist to the Obama
promise of “hope” and “change.”
As Betsy McCaughey has written in a
groundbreaking analysis of the Obama healthcare proposals,
draconian cost-control measures are not the answer to healthcare
reform and they are based on erroneous data. Healthcare’s
spending increases over the past five years have been about half
what they were in the recent period before that. Average family
spending on food, energy, and healthcare have remained the same
for decades. Moreover, contrary to myth, there are not 47 million
uninsured Americans but actually about 22 million. Rather than
pass a healthcare reform that will mercilessly limit healthcare
to older citizens (and to chronically ill citizens) while still
increasing federal expenditures by at least a trillion dollars,
she suggests a modest reform, to wit, debit cards for the
uninsured and the needy.
Appearing in a recent installment of Spectator.org, McCaughey
wrote, “Providing sliding scale assistance, based on
household income, to families to purchase…coverage would cost $20
to $25 billion a year.” That is one reform that will deal with
our present problems. There are others, which I shall take up in
later columns. What we do not need is Orwell’s Big Brother
overseeing the rationing of healthcare to senior citizens,
particularly senior citizens with years of life ahead of them.
