The Right Prescription

A Gut Check on What Obama Means by ‘Fairness’

Obama receives preventive care his HHS bureaucrats deny Medicare patients.

By 8.8.12

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Last month, the President told a crowd of supporters in Texas that he was glad his unpopular health care law is known as "Obamacare" to its opponents: "You know what, they're right, I do care. I care about folks who get sick …" This claim would have been more truthful had he told them he cares about some folks who become ill. Indeed, it would have been more consistent with his actual behavior had he said, "I care about myself when I get sick." President Obama, you see, has been availing himself of medical tests his HHS apparatchiks won't approve for payment if Medicare patients receive them.

In his routine physicals, for example, he has taken advantage of a state-of the art test shown by studies to be effective at detecting early colon cancer without exposing the patient to the potential risks associated with traditional colonoscopy: "President Obama, in his first routine physical exam as commander in chief, received a CT colonography (CTC), commonly known as a virtual colonoscopy, to screen him for colorectal cancer." A good call by Obama and his doctors. Unfortunately for Medicare patients, his HHS apparatchiks have decreed that Medicare patients will not enjoy the same quality of care.

In 2009, the government's health care bureaucrats decided, "The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test." Somehow, though, the evidence was convincing enough for the President's doctors to recommend it. And the chief medical officer of the American Cancer Society said at the time, "Virtual colonoscopy, or CT colonography, ought to be available as one of several options for colon cancer screening." So, if it's good enough for the leader of the free world, why isn't it good enough for Medicare patients? Well, one reason involved a concern "that costs would increase…"

Take a moment to consider that. The President of the United States, a public servant paid by the taxpayers, followed the advice of his taxpayer-paid doctors that he should have a taxpayer-paid CTC. Yet his health care commissars, also paid by taxpayers, have decreed that that it is too expensive to provide this very test to actual taxpayers when they retire and sign up for the Medicare program for which they have been paying all their working lives. This perverse system, it should be remembered, is not merely presided over but taken advantage of by a man who incessantly lectures these very taxpayers about "fairness."

And this is by no means the only example of Obama's peculiar brand of fairness. Paul Hsieh, a practicing radiologist and proponent of free-market health care, recently reported more of the same in a Forbes column titled, "Is the President's Prostate Gland More Important Than Yours?" Writing that Obama chose to have a PSA test when he turned 50, Hsieh points out that the rest of us may not have that option once Obamacare is implemented: "ObamaCare empowers the government U.S. Preventive Services Task Force (USPSTF) to determine which preventive health services are medically appropriate."

Does the USPSTF sound familiar? It should. It's the bevy of Beltway bureaucrats who recommended restricting screening mammograms to women over age 50. The uproar caused by that proposal caused such a headache for the people trying to pass Obamacare that HHS Commissar Sebelius was eventually forced to partially walk it back. But this bureaucracy is still animated by an affinity for rationing. And, as Hsieh writes, this affinity isn't limited to preventive care for women: "This year, the USPSTF aroused similar controversy by giving a 'D' grade ('not recommended') to routine PSA prostate cancer screening."

PSA screening is not, of course, blessed with a perfect record of accuracy. Even the American Cancer Society has stopped short of a full-throated endorsement of the test. Yet the physicians who actually treat the victims of prostate cancer, which is the second leading cause of cancer deaths, oppose the USPSTF guidelines. Hsieh links to this story about the annual meeting of the American Urological Association at which the majority of urologists present were not merely opposed to the guidelines but mad as hell about them. They are well aware of the role USPSTF will play under Obamacare and they know it will kill people.

But not the President. Obama won't have to do without a PSA or a CTC any more than his wife will have to wait until she's 50 to get a screening mammogram. Neither will ever be subjected to the tender mercies of the soulless drones with which he has filled the adumbral halls of HHS. Both will get what they need, and you will get the bill. The president has frequently said he wants everyone to enjoy the same level of care that he and members of Congress enjoy. You have no more chance of getting that under Obamacare than you do of being invited to play golf with the President or flying to Paris with Michelle to buy shoes

For the hoi polloi (i.e. you and me), USPSTF guidelines and government-imposed rationing will determine the quality and quantity of care. That's why the opponents of government-run health care use the term Obamacare in the pejorative sense. We believe it's a system that will benefit the ruling class to which Obama belongs and render life shorter and more painful for the rest of us. And, as the President succinctly put it, we're right.

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About the Author

David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.