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The Right Prescription
Obamacare’s Sales Force
How did it escape the House Republicans’ budget axe?
House Republicans plan to cut $360 million in Obamacare funding in this year’s budget. That’s a good start, enough to slow implementation of the health care law but not stop it. But not good enough to stop the administration from spending $100 million to run an ad campaign and hire a sales team to push Obamacare to thousands of doctors. That’s right. Obamacare will use a sales force (with cars and expense accounts) to convince doctors that government health guidelines are the way to go.
The home of this marketing machine is Agency for Healthcare Research and Quality (AHRQ). Its budget of nearly $1 billion a year (starting in 2014 it will be more) is scheduled to be cut by only $25 million this fiscal year. Perhaps Republicans don’t know that AHRQ is the operating system for Obamacare as well as its campaign manager.
AHRQ is mentioned in the Obamacare law 12 times. The agency and its consultants — most of them true Obamacare believers — are responsible for determining what preventive services we get, what health care “quality” is, what should be cut from Medicare and what new technologies should be paid for.
AHRQ was behind the decision to restrict breast exams to women over 50. It supplied the “evidence” for annual end of life counseling for the same seniors it decided shouldn’t get screened for depression or hip fractures. Meanwhile, it’s funding radical organizations pushing for sex change operations and the autism-vaccine link.
And it has big plans for the rest of that money. The Obama administration is not content to control what doctors do. It wants to control what they know as well. Carolyn Clancy, AHRQ’s director, talks about “embedding” directives, guidelines, and reminders into the electronic health records of every American. AHRQ is spending millions to insert clinical decision support tools for a variety of purposes. One of the most prominently mentioned: end of life care counseling.
But AHRQ is not just content to “embed” Obamacontent into the lives of every American. It is also spending $50 million to “build a marketing campaign around comparative effectiveness research. (CER).” CER is promoted as information about what are the most medically and cost-effective treatments, drugs, and medical devices. But what works and what doesn’t can change almost daily and varies by individual. Simple blood tests and iPad-equipped sensors will be able to monitor many illnesses before they spread as well as individualize treatment of a disease.
AHRQ is not only spending hundreds of millions of dollars on studies claiming there’s insufficient evidence to either use or pay for such technologies.
AHRQ is spending millions to insure that its information is found more quickly and more often on the Internet. Over 70 percent of all Americans use the Web to seek out medical information. AHRQ plans to crowd out other sources of advice by making sure Obamacontent is embedded in as many websites as possible and using search engine tools to drive doctors and patients to government friendly or supported sites.
AHRQ is spending $34 million for an ad campaign to get doctors to adopt comparative effectiveness research. Here too, the campaign is heavy on Web-based tools with the goal of trying to get AHRQ and its consultants positioned as “experts” on Twitter, Facebook, YouTube, and search engines. It is buying up ad space in medical journals, which AHRQ is also flooding with its studies claiming most new technologies are more effective than old ones.
In case doctors don’t get the message “embedded” in health records and the Internet, AHRQ is hiring hundreds of Obamacare sales reps to convince physicians that Obamacare medicine is the way to go. AHRQ’s Obamareps will be paid $20 million to sell doctors AHRQ prescriptions. For instance, AHRQ reps will tell doctors that that all diabetes, hypertension, and prostate cancer treatments are more or less the same, often using data a decade old.
Medical science is way ahead of AHRQ. Doctors are able to tailor treatments to the race, gender, age, family history of a patient, as well as the pathways many forms of cancer takes. Today new imaging technologies and genetic tests can help predict cancer risk. But AHRQ’s sales reps will tell doctors there’s no evidence they save lives.
Obamacare ‘s overlords want to monopolize medical decisions and medical information while marginalizing everything else. That goal is central to setting up the health exchanges and limiting choice. AHRQ’s multi-million marketing campaign is critical to both. Unless Congress cuts it budget to nearly nothing, it will be impossible to repeal the law and replace it with something better.
About the Author
Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest and founder of Hands Off My H ealth, a grass roots health care empowerment network. His is new book, Tabloid Medicine: How the Internet is Being Used To Hijack Medical Science For Fear and Profit, was published last month by Kaplan.
Letter to the Editor View all comments (25) | Leave a comment
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Doctor Right| 2.15.11 @ 9:47AM
"ObamaCare", in it's entirety, has been deemed unconstitutional by a Federal Judge.
This means that the implementation of "ObamaCare" must immediately cease. This includes the "sales force".
Failure to comply with the Judges decision places the Obama administration in contempt of a Federal Court.
Obama is playing a cutesy-pie game. By refusing to ask for a "stay", he hasn't acknowledged that Judge Vinson's ruling exists.
Obama has already been found in contempt of a Federal Judge for refusing to lift the ban on oil drilling in the Gulf of Mexico.
Clearly, this man has no regard for the US Constitution (which he has sworn to uphold) or the rule of law.
The Republicans control the House. It is time to begin an impeachment inquiry, and look to have this dangerous jackass (Obama) removed from office as quickly as possible.
GavInTucson| 2.15.11 @ 11:06PM
Republicans in the House don't have the stones, unfortunately, to follow through with his violation of the law.
They didn't even raise a fuss when he violated 190 years of bankruptcy law during the GM deal, where holders of secured company bonds (mainly retirees across the country) were screwed out of their money (guaranteed by law), while the UAW and it's members got dollar-for-dollar back.
It was pure political payback and a direct violation of the law, yet the Republicans said nothing.
GavInTucson| 2.15.11 @ 11:09PM
I forgot to mention that the UAW and its members were invested in GM stock which, of course, is the riskiest investment (unless you invest millions into a Democrat's campaign, apparently).
squalis| 2.15.11 @ 10:08AM
Thanks AMA, for your complicity.
buckyeman| 2.15.11 @ 10:19AM
The Obama regime is not in contempt of court until a court so rules. Judge Vinson would not even order a stay on the enforcement of Obamacare pursuant to his ruling. The Republican House could refuse to fund the massive machinery of Obamacare but they will not do so. We are all about to have a government mandated colonoscopy without sedation.
Al Adab| 2.15.11 @ 10:24AM
Along with the sales force, regulators and others involved with Obamacare, lets not forget to put the Czars (how many at last count?) on the chopping block as well. One heck of a lot of money being spent on those extra-legal autocrats.
Ken (Old Texican)| 2.15.11 @ 10:27AM
TAS,
Thank you for placing this column here today.
Above is information every single one of us must act upon...right the heck now!
Call your Reps, folks!
Tim the Enchanter| 2.15.11 @ 12:17PM
Ken- sorry, can't comply. My rep was Chris Lee (NY-26).
MikeD| 2.15.11 @ 5:59PM
Nice try tim, but I don't buy it. You need to prove to me that you really do live in Lee's district. ihink you're a liar. Prove me wrong.
Besides, think how many people live in bawney fwanks district. They get to know in really close detail what homosexuals do with each other. Plus, their representative had a homosexual whore house in his own home; yet got off the hook because he maintained that he knew nothing about why all those delicious young men were coming and going, and going and coming...and always too soon...in his very own apartment. Yup, be careful when throwing stones. Democrats live in the largest glass house in history. (With credit; and apologies, to Mel Brooks and Blazing Saddles!)
Heather| 2.15.11 @ 10:54AM
Specific links showing where you acquired the info would be very helpful in making your case (for future reference).
Ken (Old Texican)| 2.15.11 @ 11:27AM
Don't be lazy, Heather. search under...
AHRQ
Yosemeti Sam| 2.15.11 @ 11:59AM
" ... Perhaps Republicans don't know that AHRQ is the operating system for Obamacare as well as its campaign manager...."
Perhaps the HR Republicans are asleep.
Perhaps they need, when not asleep, to pass legislation - a dead man's legislative switch - to ROCK 'em to alertness from time to time.
Perhaps by Boehners' gavel upon their heads.
Serious business| 2.15.11 @ 12:23PM
Read "history" and "restored republic" at the republicfortheunitedstates (.org). I tried to debunk. I couldn't. It is all right in the Declaration Of Independence, Constitution and Bill of Rights.
Joe Oliva| 2.15.11 @ 1:30PM
This is what we get for trusting the GOP. It is called doing the same thing over and over expecting a different result, Einstein's famous definition of insanity. Well, its never too late to say I told you so.
Isn't it time we got off the elite run two party system of corruption? What is it going to take to show us that these people are all of the same stripe, the likes of which the tiger doesn't change?
2012 calls for a new way of thinking and acting if we are to ever restore Constitutional Self Government and reclaim our stolen inheritance and birthright for our kids. We need to look at the possibility of the Constitution Party and we should also investigate GOOOH.COM (Get Out Of Our House) as a way to elect true citizens legislators.
The same old same old is national suicide!
Dave | 2.15.11 @ 1:53PM
OK, kids, here's my two centavos on the subject. I've said it in other posts and will restate it -- again: As long as we conservative tilting "conservatives" continue to be lead around by this collection of inside the beltway boobs like John Boehner, Mitch McConnell and others Republican elites, all we'll end up getting is more of the same-o-same-0: "We have to work with the president; he's really a swell guy, how 'bout them Packers and more blah, blah,blah ..."
Next thing you know, the next elections are over, it's 2014 and ... Obamacare is firmly in place and the *citizen sheep (*check your mirror) are tightly locked in their government mandated cages while the Boehner's, McConnell's and McCain's are cashing in their *government funded (see: by taxpayer) pensions from the back balconies of their Caymen Island condos.
Having said that, I don't have access to the new election year planning calendar, but I'm just wonder if RINO season has been replaced by some kind of squirrel hunt?
Anyone?
Ahh, who knows? Probably the same thing.
Incidentally, for those unable to recognize Mr. Boehner in a crowded room, just look for the king size box of Super Kleenex. It oughta' be half empty.
Al Adab| 2.15.11 @ 2:06PM
Let's not forget that Mitch McConnell was one of thirteen Republicans who voted against sustaining a Reagan veto of a monsterous 18 Billion transportation pork bill. Veto was overturned.
Perhaps we need to realize these people, "have sat too long for any good they have been doing."
Joe D.| 2.15.11 @ 2:33PM
Robert M. Goldberg, this is a good start. No disrespect but we did not send them to Washington to make a good start. We sent them there to stop Obamacare including if necessary to defund it until it could be reversed. When is the last time an agency or program the government started was stopped and closed down? Once they start we are stuck with them forever.
Curtis Rasmussen| 2.15.11 @ 3:46PM
Prohibition. And they still need to shut down this Obamacare monstrosity ASAP.
kiltmaker| 2.15.11 @ 4:00PM
Let's add this $1 billion boondoggle to the cuts to the budget.
The most insidious part of this to me, is the government controlling the information that I find on the Internet. Looks like censorship, quacks like censorship, must be censorship.
The free and independent exchange of information and ideas is essential to strong and healthy nation. Freedom can be an ugly thing. It is rowdy, uncontrollable and sometimes doesn't result in the outcomes you want. But it is still the best thing ever. And our form of government, a representative republic (not a democracy) is the best expression of that freedom.
MikeD| 2.15.11 @ 5:52PM
What about it, Mr. Boehner? Are you paying attention? Please note: WE DID NOT ELECT YOU AND THE REST OF THE HOUSE GOP TO KEEP DOING BUSINESS AS USUAL!
Thank you for your attention. Now, GET TO IT!
By the way, after some difficult 'episodes' in my younger years serving my favorite uncle, my body received some things that are euphemistically called "trauma". Hmmm. It has left me less than fully functional; with 12 major surgeries required to keep me functioning at the severely reduced level that I am. But, last week, my doctor told me that EVERY DOCTOR IS STILL BEING PUSHED BY THE FEDS; UNDER THREAT OF JAIL, TO GET MY RECORDS ON LINE!
This is part of obamacare's process of getting all our medical records accessible to their DEATH PANELS so they can pull the plug on us easier from a distance.
After all, we can't have them traumatized by having to look me in the eye when they tell me they want me dead. THIS IS NOT FICTION. No matter what some lefty bleats and screams about; this is real, and it is happening! It's like living through one of Robert Ludlum's most terrifying novels about evil government gone amok and wiping out the citizenry. It's real! Am I upset? You bet; and every one of you should be too. Actually, every American should be "Mad as hell and not gonna take it any more!"
Impeach Don't Wait| 2.15.11 @ 8:15PM
"But, last week, my doctor told me that EVERY DOCTOR IS STILL BEING PUSHED BY THE FEDS; UNDER THREAT OF JAIL, TO GET MY RECORDS ON LINE!"
My gosh, if this is true, and they plan to take over the channels of information, then it's even MORE than about rationing care, it's about dictating "treatments" to the doctor, and "choices" for the patient. I'm sure this is worse than anybody imagined (me at least). If it weren't for the internet, no one would know about these goings-on. I hope Congress is reading this.
But here's what I'd like to know: Are there any doctors out there who are being pressured by threat of jail who can describe their experiences? I'd like to know more.
GavInTucson| 2.15.11 @ 11:45PM
You've basically just described the Canadian and British health care system -- equal access to garbage.
You should read their newspapers online, it'll make you sick to your stomach. No wonder the British are running back to privatization. The masses are about to revolt.
Dave | 2.16.11 @ 8:23AM
For those among us who may still be in the dark as to how something like these heavy handed ruling-mandates of the past 24+ months could possibly happen in this country we used to call America, you need look not much further than (a) the test scores and graduation rates among the (alleged) students being force feed thought through curriculum at your basic union run - government school system and (b) the political and social agendas being pumped into those young skulls of mush who manage to get preferred passage into many of those haughty factories we used to refer to as... institutions of higher learning. Then, when you get a spare moment, try chatting-up a few of the graduate brain dead who often come home and begin lecturing ol' mom and pop on their ancient old school ways of thinking. * At the end of the day, you might be stunned and amazed at the result of 4 years and thousands of dollars spent on a B.S. degree in politically correct submersion.
As one who lived through the '60s and observed what ends up being passed off today as education, I learned a very long time ago that education as we knew it probably isn't really an accurate term. Something on the order of RE-education would seem a better fit. Although, you won't see a term like that listed on any of those shiny brochures from University USA or Pelosi Tech. At least not until Mr. Cleaver's check clears.
Nope, from my section here in the Mayberry bleachers, the end result of those 90 long semesters of p.c. re-education has finally, (as the Rev. Jeremiah Wright might say) -- "come home to roost." And today ... it be roostin' big time."
As a wise and grizzled old audio engineer once schooled me: "Kid, when it comes to sound, it's garbage in - garbage out."
Check the results of your local grad then get back to me on the above grizzled rule. It probably still applies today.
(* Results are only esitmates, your grad's results may vary.)
Reebok | 8.11.11 @ 3:41AM
is good
العاب بنات | 4.11.12 @ 5:09PM
Perhaps by Boehners' gavel upon their heads.
very good