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  • When Will the Government Decide Your Health Care is Too Expensive?

    The Washington Post’s Alec MacGillis opens his article on health reform today:

    The question came from a Colorado neurologist. “Mr. President,” he said at a recent forum, “what can you do to convince the American public that there actually are limits to what we can pay for with our American health-care system? And if there are going to be limits, who . . . is going to enforce the rules for a system like that?”

    President Obama called it the “right question” — then failed to answer it. This was not surprising: The query is emerging as the ultimate challenge in reining in health-care costs that now consume $2.5 trillion per year, or 16 percent of the economy. How will tough decisions be made about what to spend money on? In a country where “rationing” is a dirty word, who will say no?

    MacGillis later reports:

    Another idea is to empower the Medicare advisory panel whose recommendations now tend to be ignored by Congress, or to create a separate, Federal Reserve-like entity to make tough decisions about federal health-care spending.

    A Federal Reserve-like entity to control how Americans spend their health care money is not a new idea. Former Sen. Tom Daschle (D-SD), who is still advising the Obama administration on health care, proposed exactly that in his book: Critical: What We Can Do About The Health Care Crisis. Heritage fellow Bob Moffit explains:

    In Daschle’s version of this new public agency, its “experts” would “oversee the health care industry” and have the knowledge and power to make “complicated medical decisions and the independence to resist political pressures.” Additionally, these government experts would “help define evidence-based benefits and lower overall spending by determining which medicines, treatments, and procedures are most effective–and identifying those that do not justify their high price tags.” This means denying payment. The health board would also:

    • Set the rules for health insurers who would participate in a national health insurance exchange and recommend benefits coverage, including drugs and medical procedures backed by “solid evidence”;
    • “Rank” therapies and medical services based on their cost effectiveness;
    • Suggest priorities for medical research; and
    • “Align incentives with the provision of quality care,” as defined by the health board, through Medicare-style “pay for performance” rules for doctors and other medical professionals who comply with government practice guidelines.

    The Federal Health Board’s power would not be limited to government-run health programs either. Moffit again:

    While the health board decisions would initially affect enrollees in government health programs, Senator Daschle says that Congress “…could, for example, link the tax exclusion for health insurance that complies with the health board’s recommendation.” Noncompliance in the private sector, in other words, would result in a severe tax penalty on employers and employees. For ordinary Americans, there would be little point in complaining to their congressman. Independent of Congress and the White House, as the senator freely concedes, the power wielded by the health board “is not small, and delegation over health policy decisions rightly raises concerns.”

    Posted in Obamacare [slideshow_deploy]

    20 Responses to When Will the Government Decide Your Health Care is Too Expensive?

    1. Gabby says:

      Sounds like a job for a "DEATH CZAR"! I say we make him wear a long black robe and carry a sickle while making said decisions too.

    2. Pingback: When Will the Government Decide Your Health Care is Too Expensive? « Conservative Thoughts and Profundity

    3. Barb -mn says:

      Good one, Gabby!

      I don't ever recall the president giving any answer with sound reasoning. In fact, at times his answer is irrelevant to the question. Just a dangerous, smooth talker.

    4. jfrye says:

      We have leader who does not respect life at the beginning, I fear care will be denied to those deemed "too far gone" As an RN, this scares me!

    5. Popblogger, Florida says:

      Not until it is made clear that Daschle's new public agency to totally regulate health care is going to regulate his personal health care and the personal health care of every politician (and their families), is such a thing even debatable. Ideas have consequences, and those consequences should be felt by everybody when it comes to health care. When tinkering with health care issues, all politicians should be warned: First, do no harm.

    6. Keith somewhere in t says:

      To win elections, candidates need over half the vote. Over half the voters must trust the President and his health care advisors. Do we trust the board to make decisions in the patient's best interest? Should we let private markets decide how to allocate care?

    7. Steve - Georgia says:

      Sounds like something out of George Orwell's 1984, a group of unelected appointees that make decisions that cannot be challenged by anyone, not even Congress. Those in Congress need to be wary as soon they will not be needed. There will be a Czar or Board somewhere doing the job they're supposed to be doing.

    8. Al, The Villages, Fl says:

      This current government is in the business of concentrating power and destroying the American Way. The only cost that is considered is whether a bill will cost votes. President Obama has learned how to speak so that the people feel good and gives his government cover to do the damage.

    9. Dennis - Indiana says:

      I am not an Obama fan and I did not vote for him. However, the need for saying NO to further medical treatment at the end of a persons life is real. Something like 80% of lifetime medical expense occurs in the last 18 months according to my sister who is an MD. Some local mechanism to decide cost effective treatment on a case by case basis is needed. Medicare is going broke. The reality is that Medicare costs need to be reduced. Yes, I will be on Medicare in about two years and this would affect me. It also needs to affect Tom Daschle.

    10. Debra, Texas says:

      Dear Dennis,

      If you really think that this rationing of healthcare will effect Tom Daschle's medical care, I have to wonder what your sister is prescribing for you. They will be exempt and that's already been decided and hardly a surprise.

      I am only 45 years old now and quite a productive member of society but I do think that rationing our senior citizen's heathcare and cutting them off when some politician (with no checks and balances which IS this administration's agenda) thinks that they have lived long enough is a sick and dangerous idea.

      It's not a surprise that on average, the majority of medical expenses are spent at the end of one's life. Chemo and radiation and other drugs that are used to save and/or extend lives are costly. Sometimes these expensive treatments are successful, buying many years of life. Sometimes they buy a precious year and sometimes they are unsuccessful. We don't spend nearly as much on healthcare when we are healthy.

      However, I don't want the government deciding at what age is a person more of a liability than an asset, therby killing them at age 65 or so. If you gave that power to some damn accountant and told them to work up an analysis and come up with an ideal age to allow someone to live, that's what would happen – and it hardly would be the first time in history that a sick society with no God and no morals did it. Not even close to the first time. Read your world history.

      I thought we we're better people than that. Our Constitution, the constitution that Obama and this administration hates does say that we are.

      As far as a solution to the medicare problem, we would do better to stop paying able bodied young people to sit at home on their rears. This would save an awful lot of the government's money (our money that is) and it could be re-distributed in an honorable way. Perhaps if Medicad didn't get an enormous amount of money, for young legal and illegal people, we would not have to consider rationing healthcare from the elderly who have worked hard all their lives and who deserve medical care at least.

    11. Tyler, PA says:

      This is very scary stuff. As a future doctor, I would be offended by a government official "advising" me what is best for my patients. Situations are dynamic and different, a politician in Washington cannot understand each patient's situation based on paperwork and statistics.

      I do agree something needs to be done to curb medicare costs. Though it seems very unethical, perhaps some costly end of life care procedures need to be reduced from medicare, otherwise the system will collapse. I understand that elderly Americans have worked all their lives and paid into the system, but at what point is it worth bankrupting the system for your children and grandchildren who are also paying into the system and will see nothing from it?

      I also agree that most young people are too lazy, I know of 3 friends of mine who are on unemployment/welfare and are not looking for a job because they have no incentive. Their taxpayer funded paycheck is apparently sufficient to not see the need to be employed, which is sickening.

    12. Walt, Boca Raton, FL says:

      The problem with he healthcare is that society wants to eat its cake and have it too. The governing individuals whether right or wrong have placed Darwinism as a center piece within its education system. In its simplified version it is the survival of the fittest. If this the dogma that is being taught, why would government take the opposite approach. The government could make the arguement that keeping people healthy and vital will help the economy, but the high end utilizers are usually elderly and will not contribute to society in an economic sense. So why is government involved in healthcare at all?

      Since government has determined that we have the right to our bodies by virtue of Roe vs Wade, should the taxpayer be asked to shoulder the economic burden of an individual's choices that adversely affect their health ( smoking, overeating, alcohol intake).

    13. Walt, Boca Raton, FL says:

      To reduce cost of healthcare the first place to start is to repeal the madatory health benefits for large employers. The original concept of providing health insurance to employees was to encourage people to work for that particular company without having to offer a higher salary. But now the companies offer plans with the employee paying partial premiums with high deductible and in most cases the limited plans offered do not cover the needs of the individual. The employ would be better suited to shop for a plan that met their needs. The problem with currently shopping for individual plans is that the insurance companies have past on the costs that are a result of offering large group discounts to large employers. If the large employers were removed from this equation, the cost of a family or single plan would be greatly reduced.

      With individuals shopping for their own plans, the individual may find it economically advantageous to modify lifestyle such as smoking cessation. The person would have a greater knowledge of what their plan covers and what their financial responsiblities are.

    14. Walt, Boca Raton, FL says:

      Nothing drive personal decisions in the why that finacial decisions do. If one were to apply it to healthcare, it would have a dramatic effect. Instead of a thrid party paying a physician for the services, have the patient pay the doctor. Then the patient may submit the reciept to the insurance company. When the patient finds the cost of care versus the payments., the person will either find a doctor that meets their needs and budget, find a more sympathetic insurance company or change their lifestyle.

    15. Terri from Ok says:

      About that common stat. that 80% of costs are in the last 18 months….

      Let's think about it.

      Who needs care?

      Healthy kids: well checks are relatively cheap.

      Young adults: a majority do not even get annual physicals outside of contraception.

      Middle aged people: Starting to need "procedures and medications" and the costs begin to add up.

      Dying people: Car accidents, trauma, gun and knife wounds, hepatitis, diabetes, cardiac symptoms, Cancer, Flu,pneumonia, blood clots, Strokes, sepsis, drowning…..We get them to a doctor, a hospital, try to stabilize and treat. These people often die within a year if they are old or frail. They ARE treatable and many will pull through if we treat them.

      BUT to "limit the care" just means do not treat the sick. Can they live longer than today? Can they be cured? It doesn't matter if the 80% stat is important to you. To shift the spending means ambulances will deliver to a morgue, not a hospital.

    16. John, Colorado says:

      Excuse me, that is, 1/4 to 1/3 of every high school graduating class since 1971, which is 18 years after 1973. The number of abortions is estimated to total something like 50 million. Fifty million Americans missing since 1973. That's a significant part of the reason for labor shortages beginning in the 1990's. It's part of the underlying demographic reason for the current recession.

    17. fred-colorado says:

      Today's comments on Tom Daschle's idea of a Federal Reserve style health structure miss the mark. In fact , a health restructuring plan as he suggests is a very good idea as it removes Washington control and places management at a more local level. In addition, local competition may permit management innovation. Unfortunately, insurance companies have declining enrollment indicating that they will not be able to fulfill all medical needs of the public. I share some of the posted comments but railing on about peoples morals, illegal immigration, and religeosity diverts focusing on MEDICAL management problems that currently exist. I'd like to hear some ideas rather than complaints.

    18. J. T. Cooper, MD, MP says:

      I have written a short movie script (The Committee) about a meeting of three "experts" that takes place a few years from now. During the meeting the Committee is charged with the final decision (or solution) as to whether fifteen patients will receive, or not receive, expensive health care,based on cost-benefit criteria. Cost to produce it should be minimal. I am willing to donate it to any group willing to make the movie and distribute copies on DVD to the general public or its members. It is copyrighted 2009, but I will sign over all rights if the movie is made. It is about 15 minutes long and should make voters angry and also afraid of what could be if we don't clean house in Congress next year.

    19. Nick B, Maine says:

      I can't understand why Universal Health Care isn't the common sense thing to do; it seems to be for the rest of the developed world. No one seems to mind us all paying for government run public schooling for everyone whether we have zero, three, or ten children. Personally, I'd rather have medicine over an education. The so-called "entitlements" should be the first things we pay for and the last we cut. I'd also rather have an elected or appointed official of the government (of, by and for the people and bound by law) than an MBA in an insurance corporation (obligated to serve shareholder and maximize profits) involved in my health decisions.

      Please explain why you don't object to private companies deciding what treatment they will pay for and which they won't. Remember, their objective is to make money and that means collecting premiums and limiting claims.

    20. Pingback: Pond’rings » Health Care in the News

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