The Health Care Rationing Commission – WSJ.com

Posted by Jason | Posted in Government, Health Care | Posted on 16-11-2009

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Here’s an article from the Wall Street Journal this morning about the rationing commission.

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.”

As envisioned by the Senate Finance Committee, the commission—all 15 members appointed by the President—would have to meet certain budget targets each year. Starting in 2015, Medicare could not grow more rapidly on a per capita basis than by a measure of inflation. After 2019, it could only grow at the same rate as GDP, plus one percentage point.

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Worse, it makes little room for medical innovations. 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. 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, including a chiropractor and a “naturopath” who focuses on alternative, er, remedies like herbs and massage therapy. They consider the clinical effectiveness but above all the cost of medical procedures and technologies. If they decide something isn’t worth the money, then Olympia won’t cover it for some 750,000 Medicaid patients, public employees and prisoners.

So far, the commission has banned knee arthroscopy for osteoarthritis, discography for chronic back pain, and implantable infusion pumps for pain not related to cancer. This year, it is targeting such frivolous luxuries as knee replacements, spinal cord stimulation, a specialized autism therapy and MRIs of the abdomen, pelvis or breasts for cancer. It will also rule on routine ultrasounds for pregnancy, which have a “high” efficacy but also a “high” cost.

Currently, the commission is pushing through the most restrictive payment policy in the nation for drug-eluting cardiac stents—simply because bare metal stents are cheaper, even as they result in worse outcomes. If a patient is wheeled into the operating room with chest pains in an emergency, doctors will first have to determine if he’s covered by a state plan, then the diameter of his blood vessels and his diabetic condition to decide on the appropriate stent. If they don’t, Washington will not reimburse them for “inappropriate care.”

via The Health Care Rationing Commission – WSJ.com.

Here is more of the government deciding that if not everyone can have the expensive medical procedures, then no one will.  If this is the way you encourage growth and innovation, I must have missed it in my Econ 101 class. I said this in a previous blog, and I’ll say it again. Jealousy of the rich, who have more health care options, does not help the middle class or the poor. It’s the rich who pay for the innovations at first, and once companies begin recouping their R&D cost and run out of rich people (there aren’t that many of them), then prices begin to decline bringing the new technology to the masses.

While the government would argue that these limits are only on government plans, we all know that eventually we are going to fall under a national health care plan with government health care for all. Government never stops once a program is implemented. It only gets bigger. Government programs have to grow and get more people dependent on them. They are similar in this respect to private companies, except private companies have to grow by you voluntarily deciding to use them. Government just changes it’s rules and forces you to abide by them.



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