The US stimulus bill passed in February 2009 contained a provision to create a Center for Comparative Effectiveness Research. Sec 1401 of House Bill 3200 further discussed the Center. The purpose of comparative effectiveness research is for the government to evaluate which medical treatments are deemed cost-effective and which are not. This may have some positive benefits, but it also lays the groundwork for denial of care as often happens with nationalized healthcare. This new center is similar to Britain’s National Institute of Health and Clinical Excellence (NICE), often praised by those who wish to implement government-run healthcare in the US.
NICE has been in place since 1999 and has been controversial in its cost-saving moves. NICE has tried repeatedly to stop breast cancer patients from receiving the breakthrough drug Herceptin and patients with Alzheimer’s disease from receiving the drug Aricept. Life-extending medicines such as those to treat renal cancers are refused on the grounds of limited resources. In 2001, NICE restricted state-insured sufferers of multiple sclerosis from receiving the innovative medicine Beta Interferon. Patients with the more severe forms of the disease were told that they would have to go on suffering in the name of politically defined fairness. In more recent years, patients with painful and debilitating forms of rheumatoid arthritis have been informed by NICE that they will not be allowed to receive medicines that have proved to be of significant benefit. Similarly, in August 2008, patients with kidney cancer continued to be denied effective treatments designed to prolong their lives, often by months or even a few years. In January 2009, NICE declared that only a small minority of patients with osteoporosis would receive the medicine Protelos, and even they would receive it only as an extreme last resort. For a time, people with macular degeneration actually had to lose their sight in one eye before the government would approve treatment for the remaining eye!
Calculations used by NICE to deny treatment have been disputed by medical experts, but usually do not fare well. Clinicians and osteoporosis support groups have pointed out that more than 70,000 hip fractures result in 13,000 premature deaths in the U.K. each year and that these otherwise avoidable episodes needlessly cost billions of pounds.
Another study found that 61% of cancer patients (27 of the 44 appraised) were denied treatment by U.K.’s NICE. http://www.ncpa.org/pdfs/Canadian_UK_HealthSystems.pdf
The main message to take away from the NICE experience is that politicians will make decisions based on what they think will get them elected or keep them elected. i.e., politicians will make decisions for political reasons, not necessarily medical reasons. The same is assuredly true for US politicians. With government-run healthcare, the government will intervene between you and your doctor. It will be the government, not the doctor and patient who decides what’s necessary. That is not the world that we want.
In case the above is not convincing to you, consider the words of Ezekiel Emanuel, President Obama;s own health adviser, written in the February 27, 2008 issue of the Journal of American Medicine: “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.” Emanuel is on record in other publications and at other times repeating his message that we need to ration our health care resources. In his article in The Lancet of January 31, 2009 Emanuel clearly indicates with a graph his belief that people under the age of 10 and over the age of 55 should receive fewer medical resources because people between the age of 10 and 55 are more ‘viable.’ As Emanuel describes it, his “…complete lives system produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance [of medical treatment], whereas the youngest and oldest people get chances that are attenuated [ie, reduced].” We find this mindset not only chilling and diminishing of human worth, but also clear evidence that the Obama administration does indeed desire to ration health care as it deems fit. (Source: Betsy McCaughey, Wall Street Journal, August 27, 2009).