Scott Geller: Guest opinion
December 15, 2009
The most serious question we should be asking about Obamacare is: What will happen to Medicare patients?
Forget what President Barack Obama tells you. Just look at the writings and statements of the individuals behind Obamacare to understand their actual intentions.
Obama has earmarked $1 billion for a new bureaucracy, the Federal Coordinating Council for Comparative Effectiveness Research, the brainchild of former Health and Human Services secretary nominee Tom Daschle.
Daschle’s (and Obama’s) stated purpose is to empower an unelected bureaucracy to make decisions about health-care rationing that elected politicians can’t.
The federal council is modeled after Britain’s NICE (National Institute for Clinical Excellence), which determines the dollar value of a Quality Adjusted Life Year (QALY). NICE allows payment for treatments that cost less than that, and disallows treatments that cost more.
Congressional Budget Office Director Peter Orszag wrote repeatedly that medicines and treatments should be rationed according to their effect in increasing QALY. Placing a dollar value on human life, Orszag wrote that a QALY was worth $50,000 to $100,000.
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Obama’s regulatory czar, Cass Sunstein, wrote a paper arguing that human life varies in value and champions methods that give preference to government QALY ratings – meaning the government decides whether a person’s life is worth living. If the government decides the life is not worth living, it is the individual’s duty to die to free up welfare payments for the young and productive.
One of the council’s most prominent members is Dr. Ezekiel Emanuel, brother of Rham Emanuel, Obama’s chief of staff. Dr. Emanuel’s views on care of the elderly should frighten anyone who is or ever plans on being old. He explains his discriminatory views as follows: “Allocation by age is not discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years.” ( Lancet, Jan. 31)
On average, 25-year-olds require very few medical services. If they are to get the lion’s share of the treatment, then those 65 and over can expect very little care. Dr. Emanuel’s views on saving money on medical care are simple: ration care. The loosely worded provisions in H.R. (House Resolution) 1 give him and his council power to push such recommendations.
Dr. David Blumenthal, another key Obama adviser, recommends slowing medical innovation to control health spending. Blumenthal has advocated government health-spending controls, though he concedes they’re “associated with longer waits” and “reduced availability of new treatments.” (New England Journal of Medicine, March 8, 2001). And he calls it “debatable” whether the timely care Americans get is worth the cost. (Ask a cancer patient; delay lowers your chances of survival.)
Americans need to know what the president’s health advisers have in mind for them. Dr. Emanuel sees even basic amenities as luxuries and says Americans expect too much: “Hospital rooms offer more privacy. Physicians’ offices are more conveniently located and have parking and more attractive waiting rooms.”
Dr. Emanuel bluntly admits the deception needed. “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change.” (Health Affairs, Feb. 27, 2008)
Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, “to do everything for the patient regardless of the cost or effects on others.” Yes, that’s what patients want their doctors to do. But Dr. Emanuel wants doctors to look beyond the needs of their patients and consider social justice, whether the money could be better spent on somebody else.
Dr. Emanuel, believes that “communitarianism” should guide decisions on who gets care. He says it should be reserved for the non disabled, not given to those “who are irreversibly prevented from being or becoming participating citizens … An obvious example is not guaranteeing health services to patients with dementia.”
Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.
Republicans tried to attach an amendment to the law to insure that nothing the council provides will be used in any rationing scheme. It was defeated by the Democrats. Can there be any clearer indication of their intentions?
It’s easy for Obama to traipse around the country promising that his health-care scheme won’t “pull the plug on Granny.” He certainly won’t be doing it. The bureaucracy he set up will do it for him.