Health Care
Debated
Emotions are running
high, from 12 different viewpoints, concerning
Obamacare. Some of the comments, on all sides,
are of questionable validity. So, on this page
VersagiVoice will try to relay reasoned
dialogue.
Pat Buchanan . . . Dr.
Fraser . . . Dr. Janda
. . . Newt Gingrich
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With "controlling costs" a primary goal
of Obamacare, and half of all medical costs
coming in the last six months of life,
"rationed care" takes on a new meaning for
us all.
London's Telegraph reported
Sunday that the National
Institute of Health and Clinical
Excellence, known by its
Orwellian acronym NICE, intends
to slash by 95 percent the
number of steroid injections,
such as cortisone, given to
people who suffer severe and
chronic back pain.
"Specialists fear," said the
Telegraph, "tens of thousands of
people, mainly the elderly and
frail, will be left to suffer
excruciating levels of pain or
pay as much as 500 pounds each
for private treatment."
Now, twin this story with the
weekend Washington Post story
about Obamacare's "proposal to
pay physicians who counsel
elderly or terminally ill
patients about what medical
treatment they would prefer near
the end of life and how to
prepare instructions such as
living wills," and there is
little doubt as to what is
coming.
The Post portrayed the
controversy as stoked by
"right-leaning radio" using
explosive language like "guiding
you in how to die" and
government plans to "kill
Granny." Yet, is not the logical
purpose of paying doctors for
house calls to the terminally
ill, whose medical costs are
killing Medicare, to suggest a
pleasant and early exit from a
pain-filled and costly life?
Let us suppose the NICE plan
in Britain is adopted. And an
80-year-woman, living alone,
with excruciating persistent
back pain, is visited by a
physician-counselor. What is he
likely to advise? What
conclusion would Grandma be led
to by a doctor who sweetly
explains what treatment she may
still receive, what is being cut
off, and what her other options
might be?
What other options are there?
Examples of how to "die with
dignity" are at hand.
Three weeks ago, Sir Edward
Downes, the world-renowned
British orchestra leader, who
was going blind and deaf, and
his wife of 54 years, who had
terminal cancer, ended their
lives at a Zurich clinic run by
the assisted suicide group
Dignitas. They drank a small
amount of liquid and died hand
in hand, their adult children by
their side.
This is the way of
de-Christianized Europe. For
years, doctors have assisted the
terminally ill in ending their
lives. Indeed, it has been
reported that indigent, sick and
elderly patients who could not
make the decision for themselves
had it made for them.
In America, we have a Death
with Dignity Act in Oregon and
such suicide counselors as the
Hemlock Society, which itself
took the cup in 2003. Now we
have Compassion & Choices, which
counsels the elderly sick on a
swift and painless end. Before
he took to ending the lives of
patients who were not terminal,
but sick and depressed, Dr.
Kevorkian had his admirers. Not
infrequently, one reads of
nursing homes where the infirm
and elderly have been put to
death.
Beneath this controversy lie
conflicting concepts about life.
To traditional Christians,
God is the author of life and
innocent life, be it of the
unborn or terminally ill, may
not be taken. Heroic means to
keep the dying alive are not
necessary, but to advance a
natural death by assisting a
suicide or euthanasia is a
violation of the God's
commandment, Thou shalt not
kill.
To secularists and atheists
who believe life begins and ends
here, however, the woman alone
decides whether her unborn child
lives, and the terminally ill
and elderly, and those closest
to them, have the final say as
to when their lives shall end.
As it would be cruel to let
one's cat or dog spend its last
months or weeks in terrible
pain, they argue, why would one
allow one's parents to endure
such agony?
In the early 20th century,
with the influence of Social
Darwinism, the utilitarian
concept that not all life is
worth living or preserving
prevailed. In Virginia and other
states, sterilization laws were
upheld by the Chief Justice
Oliver Wendell Holmes, who said
famously, "Three generations of
imbeciles are enough."
In Weimar Germany, two
professors published "The
Permission to Destroy Life
Unworthy of Life," which
advocated assisted suicide for
the terminally ill and "empty
shells of human beings."
Hitler's Third Reich, marrying
Social Darwinism to Aryan racial
supremacy, carried the concepts
to their logical if horrible
conclusion.
Revulsion to Nazism led to
revival of the Christian ideal
of the sanctity of all human
life and the moral obligation of
all to defend it. But the
utilitarian idea -- of the
quality of life trumping the
faith-based idea of the sanctity
of life -- has made a strong
comeback.
And the logic remains
inexorable. If government
intends to "bend the curve" of
rising health care costs, and
half of those costs are incurred
in the last six months of life,
and physician-counselors will be
sent to the seriously ill to
advise them of what costs will
no longer be covered, and what
their options are -- what do you
think is going to be Option A?
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A letter from a Doctor to a
Senator
A major reason that the debate is unclear is that the
bills are 1,000 pages long, assuring that almost no one has actually
read them.Going around on the
Internet is a long letter, purportedly from a Stephen E. Fraser,
MD, to Indiana Senator Bayh. Dr. Fraser writes that
"Every physician I work with agrees that we need to fix our
healthcare system, but the proposed bills currently making their way
through congress will be a disaster if passed."
The letter identifies more than 40 items of
concern, from which the following suggest the doctor's worries (line
numbers omitted). The words are all Doctor Fraser's:
Page 22: Mandates that the Gov. will audit books
of all employers that self-insure.
Page 42: The Health Choices Commissioner will
choose your HC Benefits for you. You have no choice.
Page 58: Gov will have real-time access to
individuals finances & a national ID Healthcard will be issued.
Page 59: Gov. will have direct access to your bank
accounts for elective funds transfer.
Page 95: The Gov. will use groups i.e., ACORN &
Americorps to sing up individuals for Gov. HC plan.
Page 145: An Employer MUST auto enroll employees
into public option plan. No Choice.
Page 167: ANY individual who doesn't have
acceptable HC according to Govt will be taxed 2.5% of income.
Page 195: Officers and Employees of HC Admin (GOVT)
will have access to ALL Americans finance and personal records.
Page 203: "The Tax imposed under this section
shall not be treated as tax."
Page 280: The Gov will penalize hospitals for
whatever Gov deems preventable re-admissions.
Page 341: Gov. has authority to disqualify
Medicare Advance Plans, HMOs, etc. Forcing people into Gov. Plan.
Page 425: Gov mandates Advance Care Planning
Consult . Think Senior Citizens end of life patients.
Page 425: Gove will instruct & consult regarding
living wills, durable powers of attorney. Mandatory.
Page 425 -426: Gove provides approved list of end
of life resources, guiding you in death. (assisted suicide)
Page 430: The Gov will decide what level of
treatment you will have at the end of life.
Page 494-498: Govt will cover Marriage & Family
Therapy. Which means they will insert Govt into your marriage.
Foster ends his letter:
"Senator, I guarantee that I personally will do everything possible
to inform patients and my fellow physicians about the dangers of the
proposed bills you and your colleagues are debating. Furthermore, if
you vote for a bill that enforces socialized medicine on the country
and destroys the doctor/patient relationship, I will do everything
in my power to make sure you lose your job in the next election."
Another doctor weighs in
Subject: Rationing and Denying Care
Dr. Dave Janda: THE ONE WORD TO DESCRIBE OBAMACARE
<http://patriotsandliberty.com/?p=5931>
by Dr. Dave Janda
Thursday, 23 July 2009
As a physician who has authored books on preventative health care, I
was
given the opportunity to be the keynote speaker at a Congressional
Dinner at The Capitol Building in Washington last Friday (7/17).
The presentation was entitled Health Care Reform, The Power & Profit
of
Prevention, and I was gratified that it was well received.
In preparation for the presentation, I read the latest version of
“reform” as authored by The Obama Administration and supported by
Speaker Pelosi and Senator Reid. Here is the link to the 1,018 page
document:
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
<http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf>
Let me summarize just a few salient points of the above plan. First,
however, it should be clear that the same warning notice must be
placed
on The ObamaCare Plan as on a pack of cigarettes: Consuming this
product
will be hazardous to your health.
The underlying method of cutting costs throughout the plan is based
on
rationing and denying care. There is no focus on preventing health
care
need whatever. The plan’s method is the most inhumane and unethical
approach to cutting costs I can imagine as a physician.
The rationing of care is implemented through The National Health
Care
Board, according to the plan. This illustrious Board “will approve
or
reject treatment for patients based on the cost per treatment
divided by
the number of years the patient will benefit from the treatment.”
Translation…..if you are over 65 or have been recently diagnosed as
having an advanced form of cardiac disease or aggressive
cancer…..dream
on if you think you will get treated…..pick out your coffin.
Oh, you say this could never happen? Sorry…. this is the same model
they
use in Britain.
The plan mandates that there will be little or no advanced
treatments to
be available in the future. It creates The Federal Coordinating
Council
For Comparative Effectiveness Research, the purpose of which is “to
slow
the development of new medications and technologies in order to
reduce
costs.” Yes, this is to be the law.
The plan also outlines that doctors and hospitals will be overseen
and
reviewed by The National Coordinator For Health Information and
Technology.
This ” coordinator” will “monitor treatments being delivered to make
sure doctors and hospitals are strictly following government
guidelines
that are deemed appropriate.” It goes on to say…..”Doctors and
hospitals
not adhering to guidelines will face penalties.”
According to those in Congress, penalties could include large six
figure
financial fines and possible imprisonment.
So according to The ObamaCare Plan….if your doctor saves your life
you
might have to go to the prison to see your doctor for follow -up
appointments. I believe this is the same model Stalin used in the
former
Soviet Union.
Section 102 has the Orwellian title, “Protecting the Choice to Keep
Current Coverage.” What this section really mandates is that it is
illegal to keep your private insurance if your status changes -
e.g., if
you lose or change your job, retire from your job and become a
senior,
graduate from college and get your first job. Yes, illegal.
When Mr. Obama hosted a conference call with bloggers urging them to
pressure Congress to pass his health plan as soon as possible, a
blogger
from Maine referenced an Investors Business Daily article that
claimed
Section 102 of the House health legislation would outlaw private
insurance.
He asked: “Is this true? Will people be able to keep their insurance
and
will insurers be able to write new policies even though H.R. 3200 is
passed?” Mr. Obama replied: “You know, I have to say that I am not
familiar with the provision you are talking about.”
Then there is Section 1233 of The ObamaCare Plan, devoted to
“Advanced
Care Planning.” After each American turns 65 years of age they have
to
go to a mandated counseling program that is designed to end life
sooner.
This session is to occur every 5 years unless the person has
developed a
chronic illness then it must be done every year. The topics in this
session will include, “how to decline hydration, nutrition and how
to
initiate hospice care.” It is no wonder The Obama Administration
does
not like my emphasis on Prevention. For Mr. Obama, prevention is the
“enemy” as people would live longer.
I rest my case. The ObamaCare Plan is hazardous to the health of
every
American.
After I finished my Capitol Hill presentation, I was asked by a
Congressman in the question-answer session: “I’ll be doing a number
of
network interviews on the Obama Health Care Plan. If I am asked what
is
the one word to describe the plan what should I answer.”
The answer is simple, honest, direct, analytical, sad but truthful.
I
told him that one word is FASCIST.
Then I added, “I hope you’ll have the courage to use that word,
Congressman. No other word is more appropriate.”
Dr. Dave Janda, MD, is an orthopedic surgeon, and a world-recognized
expert on the prevention of sports injuries, particularly in
children.
His website is noinjury.com <http://noinjury.com>.
________________________________
August 12, 2009 | Vol. 4, No. 32
Trust the Government
by Newt Gingrich
How much is one additional year of your life worth?
Or one more year of life for your father or your wife? For your
child?
In Great Britain, the government has settled on a number: $45,000.
That's how much a government commission with the Orwellian acronym
NICE has decided British government-run health care will pay for one
additional year of life for a British subject.
Think it could never happen here? Then you need to pay closer
attention to what Washington is planning for your health
care.
British Government Bureaucrats Literally Decide if Your Life
is Worth Living
The British single-payer bureaucrats arrived at the price of an
additional year of life in the same way they decide how much health
care all British people will get, through a formula called
"quality-adjusted life years."
That means that if you're sick in Great Britain, government
bureaucrats literally decide if your life is worth living and, if
so, how much longer and at what cost.
If it's more than $45,000, you're out of luck.
A Well-Connected White House Advocate for Allocating Health
Care
Based on Perceived Societal Worth
In the highest levels of the Obama Administration there is a theory
of how to ration health care that is troublingly reminiscent of the
British system of "quality-adjusted life years."
Dr. Ezekial Emanuel is a key health care advisor to President Obama
and the brother of White House Chief of Staff Rahm Emanuel. Earlier
this year, Dr. Emanuel wrote an article that advocated what he
called "the complete lives system" as a method for rationing health
care. You can read it
here.
The system advocated by Dr. Emanuel would allocate health care based
on the government's perception of the societal worth of the
patients. Accordingly, the very young and the very old would receive
less care since the former have received less societal investment
and the latter have less left to contribute.
"Forstall[ing] the Concern that Disproportionate Amounts of
Resources
Will be Directed to Young People with Poor Prognosis"
"The Complete Lives System" would also consider the prognosis of the
individual.
Quoting Dr. Emanuel: "A young person with a poor prognosis has had
few life-years but lacks the potential to live a complete life.
Considering prognosis forestalls the concern that disproportionately
large amounts of resources will be directed to young people with
poor prognosis."
When fully implemented, Dr. Emanuel's system, in his words,
"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."
"Chances that are attenuated" is a nice way of saying the young and
the old are considered less worthy of health care and, under this
system, will get less.
Once Government Becomes the Provider of Health Care,
Personal Decisions Become Public Decisions
The point is not that a health care rationing system like the one
favored by Dr. Emmanuel will be implemented in the United States
tomorrow.
The point is that, as in the British system, once government becomes
the single payer or even the main payer of health care, what were
once intensely personal decisions become public decisions. And as
costs rise, government will look for ways to contain them.
The inevitable result of this pressure to control costs will be
rationing, whether it occurs during this administration or the next.
At some point, the government will be forced to deny care to those
who don't meet the latest "quality-adjusted life years" cost-benefit
analysis.
So the decision on what treatment to pursue that once would have
been made by you and your doctor is now made for you by a bureaucrat
using a formula - a formula to literally determine if your life is
worth saving.
The Camel's Nose Under the Tent of Health Care Rationing
Societies don't arrive at this point overnight.
British health care was nationalized soon after World War II, but
NICE, the health care rationing agency, wasn't created until the
late 1990s as a way to control costs.
Today NICE routinely denies Britons life-prolonging drugs that are
deemed not "cost effective" - drugs that are widely prescribed in
America to treat cancer, Alzheimer's disease and other serious
conditions.
The result, studies show, is that Great Britain's cancer survival
rates are among the worst in Europe and lag behind the United
States.
In America, Rationing Begins with Comparative Effectiveness
Research (CER)
In our country, the road to dehumanizing, bureaucratic health care
rationing begins with something called comparative effectiveness
research (CER). It sounds completely innocent. In practice, CER
means comparing different treatments for diseases to see which works
best. And what doctor or patient would object to that, right?
The problem is that, in the context of a government-run health care
system, comparative effectiveness research becomes a way to find a
cheaper, one-size-fits-all approach to medicine that will limit
health care choices for patients.
But don't just take my word for it. Congressional Democrats included
$1.1 billion in the Stimulus Bill for CER. Report language
explaining the bill noted that the treatments found to be "more
expensive" as result of the research "will no longer be prescribed"
and that "guidelines" should be developed to manage doctors.
Congressional Democrats also killed several amendments to the
current health care bill that would have prevented CER from being
used to ration care. (To learn more about the common-sense
amendments to the bill that have been blocked,
click here).
The Government Has Determined You Must Take the Blue Pill
President Obama innocuously described the intended result of
comparative effectiveness research like this: "If there's a blue
pill and a red pill, and the blue pill is half the price of the red
pill and works just as well, why not pay half price for the thing
that's going to make you well?"
Listen to what the President is saying here. He's saying that the
government is capable of determining which pill works best for you
and should therefore only pay for that pill.
But this one-size-fits-all approach goes against everything modern
medicine is learning about the genetics of the human body. Different
individuals and members of different ethnic and age groups respond
differently to treatments. More and more, treatment of diseases like
cancer is highly individualized and based on a genetic analysis of
both the patient and her disease. Science is leading us in one
direction and the administration and the Congress are taking us in
the other.
What if you get sick and your doctor says you need the red pill, but
the government has determined that the blue pill is what works best
for its budget? In a single payer health world, what do you do then?
Creating a Commission to do the Dirty Work
Government bureaucrats limiting health care choices is terribly
unpopular of course, which is why politicians use terms like
"comparative effectiveness research" instead of "rationing."
Another method Washington uses to avoid complicity in health care
rationing is the creation of government boards or commissions - like
Britain's NICE - to do the job for them.
President Obama has
expressed his support for using the Medicare Payment Advisory
Commission (MedPAC), a commission created to advise Congress on
Medicare, to achieve cost savings under health care reform.
Because the commission's decisions could only be over-ridden by a
joint resolution of Congress, it would be virtually unaccountable to
the people - and nervous members of Congress could blame the
commission for unpopular decisions.
Combine this kind of a commission with the "complete lives system"
advocated by White House health care advisor Dr. Ezekial Emanuel and
you end up with a government rationing board literally determining
which Americans should live and which should die.
Just Trust the Government
Supporters of government-run health care dismiss these worries as
alarmist. They argue that because their big government health care
bill doesn't overtly call for rationing, it is somehow illegitimate
to talk about this danger.
But it is always legitimate to consider the long-term consequences
of a government program. By refusing to have an honest debate of
this issue - to explore honestly the consequences of the "painful
choices" that all supporters of government health care say must be
made - their argument boils down to nothing more than this:
Trust the government.
Trust the politicians who are passing 1000-page bills they haven't
read.
Trust the leaders who are demonizing the citizens seeking to express
their disagreement by calling them "un-American."
Trust the advisors who advocate sacrificing the weak and the old and
then hide in the shadows.
Trust the government to know what's best for the most intimate, most
personal part of you and your family's life: your health.
Go ask a British citizen if it's worth it.
To just shut up and trust the government.
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Your friend,
Newt Gingrich |
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