In a
conversation that has received much attention since it occurred in November,
conservative talk-radio host Mark Levin spoke with a neurosurgeon who reported
some disturbing information regarding ObamaCare, and the sorts of insidious and
surreptitious control that it gives the federal government over
healthcare. During the call in question,
the physician reported that he had come from a recent meeting of neurosurgeons
in which they reviewed new HHS guidelines for advanced neurosurgical care. According to their reading of the documents,
patients over the age of 70 who are on federally subsidized insurance (Medicare,
Medicaid or other “public option” alternatives) should only receive “comfort
care” in the case of a stroke, hemorrhage or brain aneurysm that would
otherwise benefit from surgical intervention.
Mark Levin vetted the caller and confirmed his identity and profession,
as well as his attendance at the referenced neurosurgical meeting. The doctor went on to describe the so-called
“ethics committees” that have been put in place by the administration to
determine where monies will be appropriated and what medical and surgical procedures
will and will not be reimbursed. The
conclusion of the ethics committee is that neurosurgical intervention is “generally
not indicated” for patients over 70. And
so it begins.
Although Sarah
Palin may have coined a somewhat inflammatory phrase in suggesting that the
healthcare reform bill included “death panels”, in a sense, she was correct; we
are clearly seeing the impact of the legislation as committees of primarily
non-medical administrators make decisions that profoundly impact the way in
which doctors and hospitals can render care to their patients. And sometimes those decisions – as in the
case of a 70 year old with a brain hemorrhage -- can be tantamount to a death
sentence.
The new
mammogram guidelines are another case in point: In this example, the “United States Preventive Services Task Force”, whose members were appointed by the
Obama administration, after reviewing years of data on breast cancer, came out
with new guidelines for mammography that contradict those of the American
Cancer Society. Instead of starting regular mammograms at age 40,
the task force said that women who were not considered high risk could wait
until age 50. And instead of once a year, the task force determined that
getting screened every 2 years was adequate.
Interestingly, the ACS reviewed the same data and held their ground,
choosing to stay with their previous recommendations. The issue here is that the guidelines were changed by the
Task Force, not on the basis of any new scientific or medical studies,
but purely on the basis of an actuarial analysis that determined that it
was not cost effective to diagnose and treat women with breast cancer
before age 50 and after age 74 – a decision that you might disagree with should
it be your wife, mother or daughter with the disease. The new guidelines
for mammography were published in November of 2009, pre-dating the actual
passage of the reform bill the following March, but were clearly a harbinger of
things to come, including the significant rationing of healthcare.
Once the
government’s guidelines for a particular medical condition have been set, the
next step is for reimbursement to be denied for those tests and procedures that
are no longer recommended. The FDA’s
recent rescinding of approval of Avastin for breast cancer, initially approved
for the disease in 2008, was likewise an economic decision, and again reflects
the obvious move toward rationing which
has been built into the ObamaCare plan. The
FDA, formerly tasked with assessing drugs purely based on their clinical safety
and efficacy, was asked in this case to opine on the economic value of the
drug, and determined that it was simply too costly to justify the “minimal
extension of life” that it generated.
Both private and public insurance companies have scaled back on their
coverage of Avastin as a result of the FDA’s decision, rendering many patients
unable to pursue the treatment. These
are just a few examples of the provisions within the bill that granted
authority to bureaucrats to promulgate rules and programs governing our
healthcare. Surgeons and other
practitioners whose specialties require significant costly interventions will
be the most impacted early on. If
certain screening exams and treatments are deemed to have unacceptable
cost-benefit ratios, they will be cut. In all of these cases, the message from
the government is clear: We are putting cost savings before human lives and
outcomes. Many, many more “new treatment
guidelines”, rescinding of drug approvals, and changes in reimbursement for
procedures will be coming down the pike, should the bill not be repealed.
Lowering
healthcare costs will require identifying and eliminating wasteful spending and
fraud in the system, improving the overall health of Americans, and allowing
the free-market to create competition and natural cost pressures. But providing for the early diagnosis and
treatment of breast cancer, and pursuing neurosurgical intervention for
patients over 70 isn’t a waste. While
the healthcare reform bill might not include the classic and repugnant concept
of a discreet panel that casts a “live” or “die” decision, individual by
individual, what it does is perhaps more insidious: sweeping, depersonalized
determinations that entire categories of people will be denied certain
treatments based on economic and age criteria.
Although people have eschewed the phrase “death panel” as inflammatory,
it is, if fact, a fundamentally correct descriptor; forcing physicians to
follow guidelines set by panels of administrators, considering economic
criteria over human lives, and weighing actuarial analyses over years of medical
education, training and experience will have exactly that effect.
story by Kelly Victory Steamboat Springs
