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The Rationing Commission?
That’s what this editorial in the WSJ calls it.
As usual, the most dangerous parts of ObamaCare aren’t
receiving the scrutiny they deserve—and one of the least examined is a
new commission to tell Congress how to control health spending.
Democrats are quietly attempting to impose a “global budget” on
Medicare, with radical implications for U.S. medicine.
Like most of Europe, the various health bills stipulate that
Congress will arbitrarily decide how much to spend on health care for
seniors every year—and then invest an unelected board with
extraordinary powers to dictate what is covered and how it will be paid
for. White House budget director Peter Orszag calls this Medicare
commission “critical to our fiscal future” and “one of the most potent
reforms.”
On that last score, he’s right. Prominent health economist Alain
Enthoven has likened a global budget to “bombing from 35,000 feet,
where you don’t see the faces of the people you kill.”
This is not really hyperbolic.
The commission is mandated to go after “sources of
excess cost growth,” meaning treatments that are too expensive or whose
coverage will boost spending. If researchers find a pricey treatment
for Alzheimer’s in 2020, that might be banned because it would add new
costs and bust the global budget. Or it might decide that “Maybe you’re
better off not having the surgery, but taking the painkiller,” as
President Obama put it in June.
In other words, the Medicare commission would come to function much
like the National Institute for Health and Clinical Excellence, which
rations care in England [NICE]. Or a similar Washington state board
created in 2003 to control costs. Its handiwork isn’t pretty.
The Washington commission, called the Health Technology Assessment, is manned by 11 bureaucrats…
If Democrats impose such a commission nationwide, it would
constitute a radical change in U.S. health care. The reason that
physician discretion—not Washington’s cost-minded judgments—is at the
core of medicine is that usually there are no “right” answers. The data
from large clinical trials produce generic conclusions that rarely
apply to individual patients, who have vastly different biologies,
response rates to treatments, and often multiple conditions.
Health care reform should protect physician discretion and patient rights. And guard against increased rationing, because…
health care’s fiscal pressures will be even stronger
than they are today if ObamaCare passes in anything like its current
form. And that is when politicians will want this remote, impersonal
and unaccountable central committee to do the inevitable dirty work of
denying care.
The only way to take the politics out of health care is to give
individuals more power to control medical dollars. And the first step
should be not to create even more government spending commitments. The
core problem with government-run health care is that it doesn’t make
decisions in the best interests of patients, but in the best interests
of government.
Just look at the newly released mammogram recommendations…..(below)
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