Of Course it’s Rationing

During the August recess, while the Community Organizer in Chief is leading the charge against communities organizing against his health care agenda, I thought I would take another look at the details, which the devil is notorious for being in.  To me, the clearest long term effect is that the health care reform will end up in health care rationing.  Not as an unintended side effect, but as the long term goal.

But no, you say, scare-monger!  Trying to frighten people from the vision of The One!  Well, maybe people should be scared.  It’s astounding to me that this plan has gotten this far.  True, the plan would have been passed months ago if Obama had been savvy enough to drop it already written onto the laps of Congress in early February.  The country was in the throes of an Obamagasm and the President figured it would last enough to get this done in the summer.  It’s easy to see how he miscalculated.  All the major media organizations are still lounging in the bed, nude, and bathing in the afterglow. But much of the country either never got their promised release, or did, and afterwards felt sticky and thirsty, with a pounding headache coming on.

It’s a simple economic truth that in the broadest sense everything is “rationed.”  That’s what money does; it determines a value for anything that there isn’t an infinite supply of, which is practically everything.  Health care in the United States costs money, so if you have a lot of money, you can get as much as you want, or like most people who don’t have a lot of money, you have a third party payer pick up the tab.  In Canada and Europe, healthcare still costs money; only the someone who is picking up the tab is the government.  In the US, the third party payers (insurance companies) compete against each other for member’s and employer contracts.  In systems where the government is the only purchaser of healthcare, there isn’t competition, or making a profit off of providing healthcare like there is in this country, only a staggering cost and annoying patients.  Wait times often do the rationing, with patients waiting many months for care in limited facilities with limited medical providers.  That’s one of the key differences between a private and government health care system.  Building more facilities and hiring more staff helps to make money in a private system, so there is a powerful incentive to expand, but for the government, it’s merely a drain on resources.

The country had a bit of luck though in that President Obama’s first choice for Health and Human Services Secretary, Tom Daschle, was derailed by tax issues.  Daschle, who had spent the years since losing his senate seat mucking about Washington as a lobbyist-who-never-registered-as-a-lobbyist also had time to write a book on health care, Critical:  What We Can Do About the Health Care Crisis.  The book lays out a plan very similar to what’s contained in HR 3200.  Daschle was quite open in how he wanted health care to be rationed; he proposed a Federal Health Board  to determine both clinical effectiveness and cost effectiveness, in other words, a board to determine approved courses of treatment in the same way that the Orwellian named NICE, the National Institute for Health and Clinical Excellence, does in the UK.

NICE determines cost effectiveness based on a formula that says that a treatment is cost effective if it doesn’t exceed $34,000 per Quality Adjusted Life Year.  That means if an anti-cancer drug costs a cool 34K, but it will only increase your life span for 6 months, then sorry, go home and die.  This insures that only the older, cheaper, treatments will be used with any regularity.  That’s why the United States, with millions uninsured, has better long term survival rates on most common cancers, like breast, prostate, and colon cancer than the state supplied healthcare of Europe.

Daschle isn’t the only one in the President’s orbit who wants to ration health care.  Dr.  Ezekiel Emanuel, brother of Chief of Staff Rahm Emanuel, is a White House advisor on health care issues and has written extensively on various aspects rationing health.  His take on rationing healthcare is based on his Complete Lives System.   As Dr. Emanuel explains his proposal:

When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.

There is even a chart showing prime ages for using expensive medical treatment, and ages when…eh not so much eh?

The gist of this proposal is that if you are between 15 and 40, you are considered a good bet to get high quality, expensive medical treatment, because these are the ages when you have the most value to society.  Under 15, not so much education or training has been spent on you, so there is no big investment.  Over 40, you are beginning the end of your highest value to society and now you are starting to cause nothing but problems, what with your middle aged health ailments. Oy!  As you can see from the chart if you are 60 or older, than it’s pretty much Soylent Green time.  Just go to the center, take your poison, watch an IMAX movie and “go home.”

Rationing is so ubiquitous among the supporters of government healthcare that there doesn’t seem to be any shyness in discussing it.  Apparently you can advocate health care rationing, just not use the word “ration” and that’s good enough.  For example, Senator Edward Kennedy wrote recently for Newsweek about The Cause of My Life:

We also need to move from a system that rewards doctors for the sheer volume of tests and treatments they prescribe to one that rewards quality and positive outcomes. For example, in Medicare today, 18 percent of patients discharged from a hospital are readmitted within 30 days—at a cost of more than $15 billion in 2005. Most of these readmissions are unnecessary, but we don’t reward hospitals and doctors for preventing them. By changing that, we’ll save billions of dollars while improving the quality of care for patients.

The problem with re-admissions of course, is that you can’t know they are un-necessary until after the patients are re-admitted.  How are you going to know which re-admissions are “unnecessary” until after they are re-admitted?  How is the government going to reward hospitals and doctors for not admitting patients to the hospital?

And of course, this goes all the way to the top, to the Rationer in Chief.  During the ABC Health Care Town Hall, President Obama made an astounding statement regarding that very subject, in response to a question from a woman who is a caregiver to her 105 year old mother, the woman told of her attempt to find a doctor to implant a pacemaker.  She finally found a doctor who found her mother to be worth saving, and the surgery was done.  Her question, would the government plan consider “a certain joy of living?” In determining who would get expensive medical care.

But what we can do is make sure that at least some of the waste that exists in the system that’s not making anybody’s mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller.

I don’t know why the President seems to think that doctors don’t already have to make those decisions, based on the health and ability of the patient to handle surgery.  Now of course, there will be a new wrinkle added, the government’s desire to pay for healthcare for the unproductive.

Rationing isn’t a joke or an over the top accusation.  It’s happening right now in other countries, and astoundingly there seems to be plenty of people who want to import the worst of socialized medicine to this country.  My wife’s grandmother is British, and at 92 has been denied the gall bladder surgery that she needs by the NICE regulations.  In this country, a 92 year old may or may not get surgery, based on the physician’s judgment that the patient is able to handle the surgery, not on government regulations and rules.

A British friend of my wife’s family, in his late 50’s was diagnosed a few months ago as needing bypass surgery and a shunt.  He has a home in Florida as well as in the UK, and wanted to fly back to the States for surgery, since he was told that he couldn’t be scheduled for surgery for months. However the National Health Service has forbidden him to fly.   In this country, go see a doctor and be told that you need open heart surgery and chances are you’ll find yourself admitted to a hospital the same day. So he is trapped in the UK, hoping he lives long enough for the scheduled surgery (hopefully by the end of August).

So this is how the government plans to “control costs.”    True, the United States spends more per capita on health care than any other nation, but that’s because, goddamn it, we want health care, and we’re buying it.  In other countries, healthcare is a line item in the national budget.  You can’t buy more of it if you want or need more.  You get what you’re allowed to have.  Why anyone would want to copy that kind of system is beyond me, but what I do understand is why the government wants it.  That’s in the nature of governments to constantly try to expand it’s power over us, and it has plenty of collaborators.

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15 thoughts on “Of Course it’s Rationing

  1. Mike: You lose credibility when you throw out hate-tinged words such as:

    The One!
    Obamagasm
    Rationer in Chief

    It automatically negates any argument you may or may not have and renders a discussion of the subject of health care moot.

    That’s the same tactics your comrades are using to disrupt town hall meetings throughout the country.

    And implores one to ignore your ignorant protestataions as uneducated and uninformed.

    Try removing the inflammatory statements from your argument above and perhaps you’ll get a response.

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  2. May I add this too, Mike?

    It certainly doesn’t help your cause when Sam (Guardian) quotes Senator Ted Kennedy in a Newsweek piece:

    http://www.newsweek.com/id/207406/output/print

    with the following quote:

    Quote
    “All Americans should be required to have insurance.”

    Nowhere, absolutely nowhere, does Senator Kennedy state that in his eloquently written piece.

    With liars (and you so love to call those you oppose liars when the real liars are your comrades!) like Sam on your side, it would behoove you to read my earlier statement:

    It automatically negates any argument you may or may not have and renders a discussion of the subject of health care moot.

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  3. I shouldn’t be surprised that this is the argument against a public health option.. the argument that we don’t want to be like Canada or Britain..
    Because it’s the classic lie coming from the GOP…

    what, is the lie?

    That we will suffer the same consequences of these systems.. even tho this is NOT the system the Dems are trying to pass..

    it’s like an argument that Pepsi is worse tasting than Coke because balut taste like shit.. seriously, what a rotten egg has to do with deciding whether Coke taste better than Pepsi makes no sense what so ever.. and it is the same as comparing the system we want with the system that is no way shape or form being presented as an option..

    But there is rarely any logic behind a GOP attack, only lies,misinformation and the complete absence of mature debate..

    take for instance the argument of “It costs too much”.. well it costs more to do nothing.. But this truth is flatly rejected because there is no arguing it.. so it goes on the shelf labeled “Ignore at all costs”.

    Also, when brought up the handbook calls for “Misdirection” to be applied until the subject has gotten off that train of thought.. which is what you have here.

    seriously, the party of the Liberals.. the party that would feed,house,clothe and school anyone one whether they can afford it or not.. the party that gives away free food stamps,gov’t cheese and would see marijuana on every 7-11 shelf.. The party of abortion,assisted suicide and drivers license for illegals…that is the party of “rationing?”

    right.. like I said.. illogical.

    But I see how this morphed… at one time the idea behind health care was cried about for costing too much.. so the Liberal said, “It’s ok because we are going to reign in costs.. instead of doctors pushing for back surgeries that has a lower success rate than a pain management regime..we’re going to make that doctor actually ‘treat’ his patient the best way possible instead of the best way to get him more money from the insurance company”“We’re going to say that when the cardiologist orders a CBC on Monday, that instead of the podiatrist ordering another CBC on Friday, he has to use the same one from earlier in the week.. unless it’s medically necessary to order a new one..”“We’re going to make sure that the money that is being spent, isn’t being spent on redundancy and inefficiency.. but only for our public option.. what you do and charge for your own private option is up to you.. but our public option, will not fall from waste…”

    to which the GOP then cried.. “Oh MY GOD! You’re going to ration health care”…

    there is no logical leap to that conclusion.. but there is also no logical leap to arguing the problems with the healthcare in the 2 countries we are NOT trying to emulate either..but both arguments make damn good sound-bites.. whether they’re true or not..which is all the GOP is cares about..

    But what you don’t care about is costs, if you did you would want to reign in the massive costs we have now…if it was about rationing, you would complain when a private insurance company decides to ‘ration’ care to their policy holder because they don’t pay for ‘new’ treatments… whether that treatment is a new cancer protocol that cost $30K and extends a life for 6 months or not..

    Giving a cheap to free public option to those who do no have it is not the Satan Highway you’ve made it to be.. but in t he end, I fear you will have won the debate any way because stupidity and fear breeds more rapid than logic and intelligence..but don’t get too complacent in your victory dance.. b/c you’re ‘let them eat cake’ philosophy will come back around to you eventually.. I hope I’m around long enough to see it..

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  4. Now, lets address the other ..uh.. mis-communication you’re trying to push..

    In systems where the government is the only purchaser of healthcare, there isn’t competition, or making a profit off of providing healthcare like there is in this country, only a staggering cost and annoying patients.

    but that’s not the system we’re vying for it is? nope, because that would be a ‘single payer’ system and that is not what the bill is trying to accomplish.. the bill wants to put in a place a safe guard for those who cannot afford or get heath insurance on their own.. whether that’s b/c they have a pre-existing condition or are unable to pay for it.. that’s it, nothing else.. your private plan will not be effected, except that it will cost less and work better.. you want to complain that I don’t argue the ‘merits’.. well, why do you lie about the argument all together?

    NICE determines cost effectiveness based on a formula that says that a treatment is cost effective if it doesn’t exceed $34,000 per Quality Adjusted Life Year. That means if an anti-cancer drug costs a cool 34K, but it will only increase your life span for 6 months, then sorry, go home and die

    that is no different than what private insurance does.. MANY ‘ration’ new and improved treatments or medications b/c they are still ‘experimental’ , even after 10 years of use…’ration’ cover transplants, or blood transfusion even in the case of emergency.. there are HMO’s out there who will ‘ration’ care from an unconscious car accident victim because the ambulance took them to an ER out of their network.. OH, but that’s ok to you.. and it’s OK b/c like being uninsured, you don’t have to worry about that kind if thing and those that do are just shit out of luck..


    That’s why the United States, with millions uninsured, has better long term survival rates on most common cancers, like breast, prostate, and colon cancer than the state supplied healthcare of Europe.

    GREAT! Phrasing.. seriously.. I had to read it twice.. the placement of the word ‘uninsured’ makes it almost seem like you mean one those kinds of ppl getting breast or protate or any other cancer has a better survival rate here than anywhere else.. .. but thats simply not true is it.. because the survival rate you are quoting is only for those with insurance… those without of course, fare much worse than any other country don’t they..


    But what we can do is make sure that at least some of the waste that exists in the system that’s not making anybody’s mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller.

    That’s right.. SOME of the waste.. not “we will kill grandma” or your down syndrome baby… SOME waste that is shown to be UNNECESSARY will be streamlined into a better option and better care.. How you bastardize that into something bad is beyond me… but the fact that you do bastardize it, shows me the level with which would are willing to stoop to to get your way… lies,lies and lies.. whatever you can do, to win at all costs.. Glenn Beck..er Lil MIke, you should be ashamed..

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  5. Between the fear mongering and false information that have been spewed out surrounding this issue, I admit, I’m lost. What I don’t understand is how some people think that what we have is fine. If you mention France being number one in health care, you’re practically branded with treason. I’m not sure getting something done is better than nothing. As long as the insurance companies are at the negotiating table, I don’t believe there will be any meaningful progress. We do know that the majority of costs go for people who are in their last 3 months of life. I don’t believe that it’s inhumane, immoral or ‘playing god’ to take a realistic approach to stopping that from being the case. Euthanasia? Yes. What if it a family member of mine? Would I still feel the same way? Yes.

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  6. Hi FaFa! It’s nice to see you commenting.

    Did you say you’re lost? As in LOST????

    Visit my blog or TVOvermind.com and you’ll be found! 🙂

    Kelly, It’s obvious Mike is passing off the same ol’, same ol’with his lies and quotes from spurious sources.

    I’ll be posting my response to him on my blog in the next day or two. As soon as I get over that crap Sam pulled. God, what a loser!

    Like

  7. Get a webboard you two! Wasting all my good comment space…

    Howey, considering your past record, I hardly think you are in a position to declare the words, The One, Obamagasm, Rationer in Chief, as “hate tinged.” They are supposed to be funny. Now you may not have found them funny, but the idea that they were used in any hate filled way is ridiculous. So no, I won’t be removing them. It’s not like I could ever expect any actual rational discussion on the issues from you. After all these years, why start now?

    You know, when you were given a monthly ban from the muche, I felt it was unfair and out of proportion to the crime and posted as much When you were given a permanent ban there, again, I felt it was unfair and out of proportion, but considering your constant proclivity in posting personal information about people without their permission, well, I have to reconsider that. It’s one thing to do it on your site, but I really don’t like you doing it on this site. That was shitty behavior on your part. Not totally unexpected, but clearly poor manners. Maybe MLG was right after all.

    Ekg, I really want to respond to your accusation of my “lies” but I may need a little specificity. You are saying looking at what happens in countries with government run health systems is not a good example of how a US government run health system would work?

    Also that it costs too much? That’s a lie?

    NICE regulations are the same as private insurers not covering experimental treatment? That’s a lie?

    That “the United States, with millions uninsured, has better long term survival rates on most common cancers, like breast, prostate, and colon cancer than the state supplied healthcare of Europe.” This is a lie? These statistics only apply to the insured?

    I just want to be clear where you think I’m lying so I can address these. Let me know if I missed any.

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  8. I think I’ve labeled them pretty clearly…

    I shouldn’t be surprised that this is the argument against a public health option.. the argument that we don’t want to be like Canada or Britain..
    Because it’s the classic lie coming from the GOP…

    what, is the lie?

    That we will suffer the same consequences of these systems.. even tho this is NOT the system the Dems are trying to pass..

    we’re not trying to get a single-payer system enacted.. so why use a single-payer system as an example?


    take for instance the argument of “It costs too much”.. well it costs more to do nothing.. But this truth is flatly rejected because there is no arguing it.. so it goes on the shelf labeled “Ignore at all costs”

    then there is the illogical leaps..

    seriously, the party of the Liberals.. the party that would feed,house,clothe and school anyone one whether they can afford it or not.. the party that gives away free food stamps,gov’t cheese and would see marijuana on every 7-11 shelf.. The party of abortion,assisted suicide and drivers license for illegals…that is the party of “rationing?”

    right.. like I said.. illogical.

    and then entire 2nd reply is pretty self-explanatory…

    it’s funny that you’re still trying to compare apples to oranges..

    You are saying looking at what happens in countries with government run health systems is not a good example of how a US government run health system would work?

    No, I’m saying if you’re going to compare to a gov’t run system..then use the correct model and not the models for a single-payer system.. you can’t compare a public option that is not single-payer to a country with single-payer.. and to do so is where the lie starts.. you can give all the facts on how horrible that single-payer system is, you can cry over the rationing the ppl under them have to go thru,you can complain about the lack of innovation in the medical field.. but you can’t use those arguments against something that is not single-payer..

    it’s like arguing how bad a Peppermint Patty taste by describing the flavor of strawberry/banana taffy…

    RE:Costs
    it costs to much to do nothing.. to keep doing what we are doing.. the public option and Obamacare will not cost nearly as much and will not add to the deficit.. so to argue about any costs, without 1st admitting that the alternative is SO much more costly.. is about as crazy as you can get.. you can’t be unhappy with the costs when they would be less than what you’re paying now..

    so the argument of Cost is out..

    RE: NICE
    You’re complaining about NICE,again unfairly since that’s single payer, an 2ndly ignoring that this kind of thing is already going on today but with the private sector being the arbiter of what can be ‘rationed’.. You cant argue that a FOR-profit entity can make a better decision on the personal health treatment for ppl when their whole goal is to make money and the only way to do that is to deny claims and cut the amount they have to spend on you, VS. a NON-profit entity that’s goal is your health..

    RE: STATS
    I’m asking the statistics for the ppl without coverage and cancer.. what is their long-term survival rate.. you’re only using the statistic of those with coverage to prove how great our system is compared to single-payer NICE.. but you’re leaving about a hefty chunk of the population by ignoring that 1st off, that stat is only for ppl who have not only health insurance, but great coverage that will allow them to be treated in the proper fashion.. 2ndly, that there a millions with coverage that they find to be extremely limited and inadequate when it’s too late to do anything about it and 3rd, you ignore the ones without health coverage all together.. Your blanket statement doesn’t cover any of those factors so it is so skewered to be bordering a pretty large lie b/c it doesn’t quantify that you’re only talking about the small part of the population with amazing heath coverage..
    This comparison also ignores that even tho a single-payer system may give a slightly lower long-term survival rate, that that rate includes everyone in the control and not just the small population with coverage..

    did you forget that part? or is it that it didn’t play into your ‘fear’? Everyone is treated under a single-payer system so not only will the average vary because you have more numbers included… but everyone is getting screened and treated for their breast and prostate cancers… as opposed to here where your statistic only applies to those who can afford treatment

    and we’ll just start with those for now.. since I doubt you’ll get to even 1/2 of them..

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