The Healthcare Rationer Cometh

President Obama has just made a recess appointment that, in my opinion, confirms what many of us have been saying for quite a while: That the current administration is committed to, and is acting to implement, a ghoulish system of government deciding who will receive medical treatment and who will go without.

The pieces of the puzzle continue to fall into place, most significantly having Zeke Emanuel as senior healthcare advisor behind the scenes. Emanuel and some of his colleagues suggested several years ago that it made the best economic sense to concentrate the vast majority of healthcare dollars on those older than 15 (because they have their whole productive life ahead of them) and those younger than 40 (because thereafter medical care generally starts to become more expensive all the way to the end of your life).

After a presidential campaign that went to great lengths to spin public perception away from healthcare rationing and socialized medicine while vilifying the opposition, now the truth emerges. The President’s recess appointee, Dr. Donald Berwick, is an unabashed fan of healthcare rationing.

Berwick has just been appointed (in recess because the President is well aware that getting this appointment approved by congress wouldn’t happen) to head the Administrator of the Centers for Medicare & Medicaid Services.

Here’s what we’re getting, in Berwick’s own words:

In an interview last year in Biotechnology Healthcare:

The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom and also, to some extent, the Institut National de La Sante in France have developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn. . . . Indeed, those organizations are functioning very well and are well respected by clinicians, and they are making their populations healthier and better off.

And, in the same interview, referring to NICE:

NICE is extremely effective and a conscientious, valuable, and — importantly — knowledge-building system. The fact that it’s a bogeyman in this country is a political fact, not a technical one.

And just in case you miss the point, Berwick goes on to say:

The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.

And here’s what Politico reported:

His comments on Britain’s NHS are drawing the most scrutiny. Berwick calls the system “far” from perfect, but he also describes it in glowing terms, citing elements that the American system lacks: universal coverage, “centralized stewardship” and guaranteed care regardless of income.

“I fell in love with the NHS,” Berwick said in a 2008 speech of the system that he had worked on since the 1990s. “To an American observer, the NHS is such a seductress. ... Like any lover, it took me a while to see the blemishes of my beloved, though I soon had help from people quite willing to point out the warts. . . .The NHS is one of the great human health care endeavors on Earth,” Berwick said in the speech on file with the Senate Finance Committee and circulated by Republicans. “It can be an example for the whole world — an example, I must say, that the United States needs now more than most other countries do.”

Uh-huh.

Only one problem: The UK’s National Health Service is a healthcare nightmare, where in the name of making healthcare equitable, people die unnecessarily by the hundreds of thousands, where many hospitals are only a step above cesspools, and is too often the last haven of many incompetent medical personnel.

We’d better wake up before we have to get in line for months for critical care, or be denied treatment because we’re too old, or too young, or just because the government won’t let us have it.

This Is What Government-Run Health Care Looks Like

Those of us who see Obamacare as a distinct step backwards are often branded as alarmist and out of touch. When we point to the regular horrors of government run systems, especially the UK, we’re shouted down with healthy dollops of “it-can’t-happen-here-because-the president-said-it-won't.”

Read on.

But before you do, look at this photo from London’s MailOnline:

Not pretty.

It’s a photo taken in a UK (government run) hospital of 84-year-old Clara Stokes. The photo was taken by her outraged daughter who discovered that her mom was living a nightmare – starved, dehydrated, and lying in her own feces.

Apparently, the ward was very short-staffed, to the point that Clara's family members were not only forced helped her, but also other patients who were in similar circumstances.

Here's a partial list of horrors. If this isn't clear, cold abuse of a person with a severe medical disability, I don't know what is:

Maltreatment 1:

Doctors and nurses who misplaced health notes even thought Mrs Stokes was a man for the first two days, after she was admitted on December 16.

Maltreatment 2:

A temporary nurse misread Mrs Stokes' notes and forced uncrushed tablets down her throat, almost causing her to choke to death.

Maltreatment 3:

She [Clara's daughter] added: 'We finally walked in and my daughter said what is that under her arm? We lifted it up and she was covered in her own diarrhoea.

Maltreatment 4:

Helpless and confused after suffering a stroke, the 84-year-old was left dehydrated, hungry and lying in her own faeces in a hospital bed for six hours. . . . 'She was paralysed and couldn't call for help. This was after 3pm in the afternoon and the last time she had been checked was at 9am.'

Maltreatment 5:

Just 24 hours later the family found a stricken Mrs Stokes' foot trapped between bed posts caused by a faulty bed pump. It was not known how long she was trapped and had to be freed by the matron.

The hospital, of course, denies, denies, denies. Here’s part of the snippy statement issued by the hospital spokesperson:

'We regret that Mrs Stokes' family have felt the need to complain about her care while she was on ward 17 and ward 15 and the hospital has apologised for any distressing circumstances recognising how upsetting some aspects of personal care can be for relatives.

Stay tuned, because I’ll bet my last dollar that the pro-death crowd will spin the horrible photo above as a case of people dying “without dignity,” and use it as a propaganda tool, captioning Clara’s abuse with: This is not dying with dignity: Support legalized assisted suicide and euthanasia.

Useless Eaters . . No, Wait, “Complete Lives”

As jackbooted healthcare legislators attempt to force on us a bill that most people don’t want and that we can’t possibly pay for, we had better understand what this will likely mean.

First: The government will become your doctor.

Here’s how it will work:

You go to your doctor with symptoms a, b, and c.

After tests, your doctor or a specialist makes a diagnosis which determines what medical treatments are necessary.

The government is paying for your treatment, so the government decides which treatment you should get - if any at all.

The treatment the government decides you should get may well be based on a proposed treatment allocation idea called the Complete Lives System and devised, among others, by Dr. Ezekiel Emmanuel, President Obama’s Special Advisor for Health Policy.

The policy is laid out on a recent article in the Lancet. This from pages 428-429:

When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated . . . the complete lives system justifies preference to younger people . . . Additionally, the complete lives system assumes that, although life-years are equally valuable to all, justice requires the fair distribution of them.

Here’s what this means in plain language:

1. The Complete Lives System will divide Americans into those who are more worthy of treatment and those who are less worthy of treatment. Top priority will go to those between 15 and 40 (because they have the best potential for longer, healthier, and more productive lives, that is, “complete lives”).

2. The youngest and oldest will have less chance of a shot at medical treatment because, statistically, the chances of them attaining "complete lives" are much lower than among 15-40 year- olds.

3. Oh, yes, and even those lucky 15-40 year-olds who make the privileged cut might not get what they need, because “complete lives” will have to be distributed “justly” across the population.

There it is:

Living, or have great potential for a “complete” life? Between 15 and 40? The Government will likely OK necessary medical treatment (unless, of course, what should have been coming to you needs to be “justly" given to someone else).

Living, but don’t have such a great potential to get to a “complete” life? Younger than 15? Older than 40?

You are judged incomplete. You are damaged. You have little potential for attaining completeness.

Complete, you live.

Incomplete, you die.

First They Came for the Mammograms….

There’s been a great deal of consternation over the last few days about the US Preventive Services Task Force recommending new guidelines for breast cancer screening and evaluation. Essentially, the task force recommends that routine screening begin at age 50 and is probably statistically useless after 75 or so. They further suggested that breast self-examination is so unreliable that women shouldn’t bother.

The history of when to begin screening women for breast cancer has a long history, as noted by ABC News. The guidelines have shifted over the years depending on what the latest studies showed.

It’s also important to understand that conflicting findings are very common in all forms of research and often leave the public confused or increasingly unwilling to believe in the accuracy of any research findings at all.

The task force’s report, however, concerns me for two other reasons.

First, the recommendations are based on statistical significance. All that means is that across all women, the most likely age for getting breast cancer is around 50 or older. Also, across all women, screening after 75 is not recommended because, statistically, they are near the end of their lives anyway.

See the shift? Breast cancer intervention based on probability, not individual medical needs.

Second, the recommendations will inevitably lead insurance companies to adopt the guidelines, which are obviously in their favor, because they can justify not paying for mammograms for women younger than 50 or older than 75. And if insurance companies know anything at all, it’s about probability and statistics.

Which brings us to rationing. The US Senate will debate its healthcare monstrosity tomorrow. Aside from all the other spending-into-oblivion by the current administration, the money to be spent in this bill will inevitably result in needed medical care far, far outstripping the resources to pay for it.

Decisions will have to be made. Some will get breast cancer screening, others will not. Guess what this will mean for your 76 year-old mother?

But the Obama administration didn’t wait for the prestigious semi-independent US Preventive Service Task Force. They have already set up an official government mechanism for using research to justify rationing: The Federal Coordinating Council for Comparative Effectiveness Research Membership.

A whole new bureaucracy to tell us what care we may or may not get by telling us that the “research” has made it so.

The government giveth, the government taketh away.