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IT'S ALL A DEATH PANEL: THE TRUTH ABOUT OBAMACARE
By DICK MORRIS & EILEEN MCGANN
Published in the New York Post on August 17, 2009
Washington is all atwitter about "death panels": President Obama derides the
idea that his health-care reform calls for them; the Senate is stripping "end of
life" counseling language from its bill -- and last Friday the voice of the
liberal establishment, The New York Times, ran a Page One story "rebutting" the
rumor that ObamaCare would create such boards to decide when to pull the plug on
elderly patients.
But all those protests miss the fundamental truth of the "death panel" charge.
Even without a federal board voting on whom to kill, ObamaCare will ration care
extensively, leading to the same result. This follows inevitably from central
features of the president's plan.
Specifically, his decisions to (1) pay for reform with vast cuts in the Medicare
budget and (2) grant insurance coverage to 50 million new people, vastly
boosting demand without increasing the supply of doctors, nurses or other care
providers.
Whether or not he admits it even to himself, Obama's talk of cutting
"inefficiencies" and reducing costs translates to less care, of lower quality,
for the elderly. Every existing national health system finds ways to deny
state-of-the-art medications and necessary surgical procedures to countless
patients, and ObamaCare has the nascent mechanisms to do the same. With the
limited options that Obama's vision would leave them, many will find that "end
of life counseling" necessary and even welcome.
"Reform" would cut care to the elderly in several ways:
* Slash hundreds of billions from Medicare spending, largely by lowering
reimbursement rates to doctors and hospitals for patient care.
If a hospital gets less money for each MRI, it will do fewer of them. If a
surgeon gets paid less for a heart bypass on a Medicare patient, he'll perform
them more rarely. These facts of the marketplace are not only inevitable
consequences of Obama's cuts but are also its intended consequence. Without
them, his savings will prove illusory.
* Expanding the patient load by extending full coverage to 50 million Americans
(including such "Americans" as illegal immigrants) without boosting the supply
of care will force rationing decisions on harried and overworked doctors and
hospitals.
People with insurance use a lot more health-care resources -- so today's
facilities and personnel will have to cope with the increased workload. Busy
surgeons will have to decide who would benefit most from their treatment -- de
facto rationing. The elderly will, inevitably, be the losers.
* The Federal Health Board, established by this legislation, will be charged
with collecting data on various forms of treatment for different conditions to
assess which are the most effective and efficient. While the bills don't force
providers to obey the board's "guidance," its recommendations will still wind up
setting the standards and protocols for care systemwide.
We've already seen Medicare and Medicaid lead a similar race to the bottom with
their formularies and other regulations. With Washington dictating what every
policy must cover and regulating all rates, insurers and providers will all have
to follow the FHB's advice on limiting care to the elderly -- a de facto
rationing system.
* In assessing whether to allow certain treatments to a given patient, medical
professionals will be encouraged to apply the Quality-Adjusted Remaining Years
system. Under QARY, decision-makers seek to "amortize" the cost of treatment
over the remaining "quality years of life" likely for that patient.
Imagine a hip replacement costing $100,000 and the 75-year-old who needs it, a
diabetic with a heart condition deemed to have just three "quality" years left.
That works out to $33,333 a year -- too steep! Surgery disallowed! (Unless of
course, the patient has political connections . . . )
Younger, healthier patients would still get the surgery, of course. The QARY
system simply aims to deny health care to the oldest and most infirm,
"scientifically" condemning them to infirmity, pain and earlier death than would
otherwise be their fate.
In short, ObamaCare doesn't need to set up "death panels" to make retail
decisions about ending the lives of individual patients. The whole "reform"
scheme is one giant death panel in its own right.