12.31.2009 0

The Dark of Night

  • On: 01/04/2010 09:27:46
  • In: Health Care
  • by Victor Morawski

    Paradoxically, some things occur in the dark of night can be seen best in the clear light of day. Such was the case recently when South Carolina Senator Jim DeMint challenged a last-minute provision inserted into the Senate Health Care Bill at 1:00 in the morning and exposed it for all the world to see.

    The provision established an “Independent Medicare Advisory Board.” And despite a disclaimer to the contrary, it will likely be the deadly vehicle for rationing health care to senior citizens. Remember: the Civil Rights Act of 1965 imposing oppressive workplace quotas was billed as containing no affirmative action. And the legislation that opened the door to tens of millions of illegal immigrants in 1985 was entitled the “Immigration Reform and Control Act.” So much for taking politicians at their word.

    The fact is, the Board will play a central role in implementing vast cuts to Medicare in the coming years — cuts that will inevitably result in rationing health care for seniors. Yes, the bill does contain a clause stating, “The proposal shall not include any recommendation to ration health care. “ And that, in truth, makes it all the more suspicious.

    We all know the old cliché, “When someone tells you, ‘It’s not about the money’ – it’s about the money!” By the same token, when politicians tell you, “It’s not about the rationing,” get ready for the rationing! This can be easily gleaned from the few sections surrounding the disclaimer.

    The politicians tell us that the main purpose of the Board is to provide recommendations “to reduce the Medicare per capita growth rate.” Now, how else are they going to reduce the average rate of Medicare spending per individual without significantly reducing the number of services – particularly high-cost life-saving services?

    Of course, they will tell you that they will do this in part through the elimination of waste. What they won’t tell you is that some of what they consider to be ‘waste’ are expensive, but potentially life-saving, services provided to those who have only a relatively short time to live (even after a successful procedure).

    The Board supposedly “will extend Medicare solvency” by focusing on “health outcomes” such as “quality and efficiency improvements.” Providing Medicare funds for high-cost procedures that result in limited benefits because they do not sufficiently (in the eyes of government bureaucrats) extend a person’s life, or improve its quality, is to them an inefficient use of such funds.

    Medicare would today cover these services because it provides them as needed, without making decisions based on projected outcomes. Architects of the current Health Care Reform Legislation are out to change this.

    Now, to make such “quality and efficiency improvements,” the Board will need data on which to base its life and death decisions. So, to “address gaps in quality, efficiency, comparative effectiveness information and health outcomes measures,” the Bill provides for the establishment of a Federal Coordinating Council for Comparative Effectiveness Research. This entity will provide the needed data. This organization parallels in its main functions Great Britain’s National Institute for Health and Clinical Excellence (NICE), which for many is the very paradigm of what Sarah Palin rightly declared a “Death Panel” style rationing board.

    One might here object that there is no mention in the current Health Care Reform Legislation of the use of a standard like Britain’s Quality Adjusted Life Years (QALY) to measure the effectiveness of services and procedures in terms of their outcomes in ways that would load the deck against the elderly, as that system does.

    But, the beauty of the new healthcare paradigm is that it doesn’t have to. For, working just down the road at the Office of Information and Regulatory Affairs is Cass Sunstein.

    Sunstein, the “Regulations Czar,” wants to change the standard by which all Federal Agencies evaluate the effectiveness of a policy or procedure from one that does not currently take any age considerations into account — the “Value of a Statistical Life” — to one which does. His standard — the “Value of a Statistical Life Year” [VSLY] – would, he readily admits, “likely result in significantly lower benefits calculations for elderly people.”

    As Sunstein’s recommendation, if adopted, would apply to all Federal Agencies, it would apply also to the Independent Medicare Advisory Board. Which may explain why the duplicitous Democrats decided to pass it in the middle of the night, thoroughly befitting the coming darkness.

    Victor Morawski, professor at Coppin State Unversity, is a Liberty Features Syndicated writer for Americans for Limited Government.

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