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.
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.
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.
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.
blog founded by Kelly Victory
written by Kelly Victory MD copyright 2012 all rights reserved
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.
blog founded by Kelly Victory
written by Kelly Victory MD copyright 2012 all rights reserved
