Special Report

Obamacare Could Kill You

If the President-elect's health care czar has his way.

By 1.15.09

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There can be little doubt that Barack Obama's promise to fix the U.S. health care system was an important ingredient in his recent triumph over John McCain. However, while a majority of voters obviously favor some sort of reform, it isn't at all clear that they understand what the President-elect and his health advisors have planned for them. Indeed, a recent Zogby poll suggests that the President-elect's supporters have managed to remain remarkably innocent about his history and proposals. It is probable, therefore, that many people who believe they voted merely for what the Obama-Biden campaign site calls "affordable and accessible" health care will be unpleasantly surprised by the "reform" they are about to get.

A case in point involves a proposal put forth by Obama's "health care czar," Tom Daschle. It is unlikely that many of the President-elect's supporters realize that Tom Daschle advocates the creation of a federal health care bureaucracy whose decrees will supersede the judgment and decisions of physicians and their patients. This "Federal Health Board," as Daschle refers to his proposed behemoth, would be modeled on Great Britain's National Institute for Health and Clinical Excellence (NICE). In the UK's socialized medical system, NICE is the bureaucracy responsible for determining the value and effectiveness of medical treatments and procedures. And it regularly hands down death sentences to gravely ill patients.

One of NICE's many victims is Jack Rosser of South Gloucestershire. Rosser has advanced kidney cancer and would likely benefit from Sutent, a drug widely used in the United States for such patients. Rosser's doctor has said that Sutent could well add years to his life. However, as Bloomberg reports, "The U.K.'s National Health Service (NHS) says that's not worth the expense." Specifically, a preliminary recommendation by NICE held that Sutent and several other cancer drugs should not be funded "in light of their cost." And local NHS authorities, including those in Gloucestershire, rarely defy the "recommendations" of NICE. So, in the words of Rosser's wife, "They are sentencing him to die.''

Can Daschle really favor such outrages in the United States? Yes he can! In his book, Critical: What We Can Do About the Health-Care Crisis, Daschle specifically cites NICE as the model for a "successful" government bureaucracy: "In other countries, national health boards have helped to ensure quality and rein in costs.…In Great Britain, for example, the National Institute for Health and Clinical Excellence…is the single entity responsible for providing guidance on the use of new and existing drugs, treatments, and procedures." And, lest you think that he doesn't intend his board to be as powerful as NICE, here is what he says about those who may object to its decrees: "Doctors and patients might resent any encroachment on their ability to choose certain treatments, even if they are expensive or ineffective." Any guesses as to who decides whether care is "ineffective" or too "expensive"?

But surely Congress, even under the control of the Democrats, would never stand for such a thing. Well, the tone of Daschle's initial Senate hearing was not encouraging for those depending on the legislature to check the excesses of the executive branch. Even the New York Times found the hearing to be nauseatingly obsequious: "The hearing before a Senate health committee was mostly a love-fest as senators from both parties expressed admiration for their former Senate colleague…" In fact, part of Daschle's strategy for gaining congressional support for his Federal Health Board is to provide his former colleagues with political cover. As he puts it in his book, "I suspect that most members of Congress would be glad to be rid of their responsibility for controversial health policy decisions."

And, make no mistake about it, these "controversial decisions" will produce corpses. In fact, NICE has moved beyond mere denial of life-saving medication to gravely ill patients. It has also recommended that the NHS abandon the "rule of rescue," which requires clinicians to treat dying patients without regard to cost. The Telegraph reports, "The NHS should not always attempt to save someone's life if the cost is too much, the medical regulator [NICE] has ruled." But how much is "too much"? What's a life worth? You and I might think this question hard if not impossible to answer, but NICE is not encumbered by our limitations. It has actually assigned a monetary value to human life.

The New York Times reports, "A British government agency, the National Institute for Health and Clinical Excellence…has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen's life." The Times tells the story of Bruce Hardy, yet another patient from whom cancer treatment is being withheld by Britain's health care bureaucrats. To the Gray Lady's credit, the piece points out that it would be different if the patient were an American: "If the Hardys lived in the United States… Mr. Hardy would most likely get the drug, although he might have to pay part of the cost." The U.S. health care system, phony studies about people dying for lack of insurance notwithstanding, does not let people die simply because treatment is expensive.

Barack Obama's health care czar wants to change all that. Tom Daschle wants to get costs under control, and he believes a federal health care agency modeled on NICE will accomplish that goal. And his boss is very much behind him on this. The President-elect has repeatedly said that the idea of a Federal Health Board "holds great promise" for "giving this nation the health care it deserves." But do we really deserve a health care system in which soulless bureaucrats arbitrarily put a dollar value on our lives, in which gravely ill patients are allowed to die because treatment costs too much? Do we really deserve to be treated the way Jack Rosser and Bruce Hardy have been treated? Not even Barack Obama's supporters, for all their naiveté, deserve a health care system that might kill them.

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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.