Aug 11 2009

Cutting Health Care Cost = Rationing = Dying

Published by at 10:52 am under Obamacare

Update: Ed Koch of all people (die hard democrat) is also sp0oked by the comments of President Obama’s advisors as noted by Betsy McCaughley (article link below video):

Most alarming for people like me, who at 84 years of age recently needed a quadruple bypass and aortic valve replacement, are the pronouncements of President Obama’s appointee, Dr. Ezekiel Emanuel, brother of Obama’s Chief of Staff Rahm Emanuel, who, according to a New York Post op ed article by Betsy McCauley, former Lt. Governor of the State of New York, stated, “Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, ‘as an imperative to do everything for the patient regardless of the cost or effects on others’ (Journal of the American Medical Association, June 18, 2008).” He also stated, “…communitarianism’ should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those ‘who are irreversibly prevented from being or becoming participating citizens…An obvious example is not guaranteeing health services to patients with dementia.’ (Hastings Center Report, Nov.-Dec. ’96). ”

Opponents of Obama’s health care proposals raise the specter of a panel making decisions on who should receive health care. I am not aware of any proposed panel. However, an article in today’s New York Times, referring to a Senate bill, stated, “The legislation could have significant implications for individuals who have bought coverage on their own. Their policies might be exempted from the new standards, but the coverage might not be viable for long because insurers could not add benefits or enroll additional people in noncompliant policies.”

So, where lies the truth? I don’t know. But I do know that I want the continued right to purchase and have available insurance that will permit me, no matter my age and physical condition, to purchase with my own money all the medical care I can afford.

You and many millions more.

Update: Let’s take a hard listen to what the President’s own advisors on Health Care have had to say about rationing/triage:

Listen well, because even the President’s own team is admitting the only real cost savings is to end the heroic efforts to help people and make decisions based on value to society for the money required. Frightening stuff. Take the time to listen to it all.

Here is the article mentioned in the video. Make sure to read it and keep a copy handy.

Update: Some liberals think just because an insurance company doesn’t provide coverage that is the same a government run death panel refusing care because of cost savings. Of course, that is a moronic argument from a moron. Under the government run plan there will be no outside options (unless you work for Congress of course). You will not be able to pay for the procedure yourself, unless you go black market. In this country you can buy plans with varying levels of coverage – it a choice between what is covered under insurance and what must come out of pocket. 

But under Obamacare nothing will be able to come out of pocket – without total control of the health industry government cannot ‘control’ costs and eliminate competition. That is the difference between rationing health care and shouldering the cost of health care. As noted below, people have died because of the UK’s death panels, and recently they have considered giving up totally on curing to focus on just keeping the healthy healthy. No private insurance plan could stay in business doing that! But a government monopoly can. And that’s why liberal morons cannot be allowed to destroy our health care system.

Other morons claim their will be no panels decided what services will be allowed and who will be allowed to access them. Geez, then how will the liberal government run health care cut costs? The people are truly naive, or flat out lying. Note to ABC News – the term ‘death panels’ was not meant to be taken literally. – end update

While there are cases of over testing or over medicating in our health care system, the wasteful overuse of health care is NOT a rampant problem. HMOs and insurance companies and government run Medicare/Medicaid pretty much keep over use to a minimum.

The largest waste in the system is the mountains of inane paperwork required by the government. So far no sane answer to that has arisen in the liberal democrat health care schemes and my bet is they would increase that waste many times over before they are done.

There is no Tort reform proposed either, another drain of precious health care dollars.

So, how are the liberals in DC going to make good on reducing the cost of health care? Their ultimate goal is a government run system like they have in the UK – single payer. It makes health care cheap to the consumer, but not cheaper – and definitely not better and not faster. There is no such thing as faster, better, cheaper in reality – let alone the federal government. Anyone who claims otherwise is a con artist or a dupe.

The underlying premise of the UK health care system is rationing care. They are quite open about it and use the word ‘rationing’ whenever they have to cut back to keep within their national budget. And when you ration, you triage:

In advanced triage, doctors may decide that some seriously injured people should not receive advanced care because they are unlikely to survive. Advanced care will be used on patients with less severe injuries. Because treatment is intentionally withheld from patients with certain injuries, advanced triage has ethical implications. It is used to divert scarce resources away from patients with little chance of survival in order to increase the chances of survival of others who are more likely to survive.

This is, in essence, the thinking behind the liberal’s health care scheme. It has been reported many times that Obama’s experts on rationing health care are following this path to cost reduction, since it is the only viable option to cost reduction in their plans (no paper work savings, no competition outside destroying private insurance companies, no Tort reform).

This system incorporates five principles: youngest-first, prognosis, save the most lives, lottery, and instrumental value. … When implemented, the complete lives system 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.

Original source here. Attenuated is a nice $10 word for triage or rationing. Again, without any other serious costs cutting measures the only way to cure costs is to ration/triage care. This is how it is done in the UK, and this is the result:

Fifteen patients from one hospital have died waiting for heart operations on the NHS, surgeons said yesterday.

Doctors at Bristol Royal Infirmary took the unprecedented step of revealing the death toll as they branded the Govern-ment’s approach to heart surgery as a ‘short-term fix’.

They are angry that Bristol, a major regional centre for heart surgery, still has a 16-month waiting list. Patients in France and Germany wait a maximum of two months before life-saving heart operations.

Franco Ciulli, chief of cardiothoracic services at Bristol, said: ‘The longer the waiting lists are, the more deaths you will get. This is 15 too many. This is 15 people who were never able to get access to services in Bristol.

‘The easy solution to the problem is more beds, more nurses and more facilities.’

Many of those who died were routine cases, meaning they may have suffered angina but were not considered ’emergencies’.

The problem is when you delay treatment complications arise – always. So even ‘routine’ cases can cascade into serious ones. My personal experience has been with my Dad, who had mild heart attacks twice. Waiting time was less than a day and the result was more than a decade of additional life. He could have easily been one of those 15 since his heart attack was mild, though his artery blockage was really bad. If he had been considered capable of ‘waiting’, he may not have made it.

In the UK the system is so strained that a million people go waiting over a year for treatments of all kinds:

More than a million patients are still waiting over a year for treatment on the Health Service.

One in ten wait for more than 12 months and a quarter more than six months, according to figures.

Overall 72 per cent of patients who completed their treatment in August waited less than the Government target of 18 weeks.

The TARGET is 4.5 months for treatment! That is their damn goal! I see lots of change and no hope when it comes to Obamacare and the government run ‘option’. 

So when Sarah Palin says there will be an Obamacare death panel to triage who has the better chance to live or die, she is not making anything up:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Not only evil, but up and running in the UK. Who do people think decides your place in the queue of hope in the UK? A panel does. And what factors do these panels use to decide who does or does not get treatment in the UK? Those of us in America used to the worlds best and most accessible health care would be shocked. 

Already around one in ten hospitals refuse to carry out joint replacements for obese patients or orthopaedic surgery on smokers.

The contract, first floated by Tony Blair was proposed by Gordon Brown in a New Year message to Health Service staff today.

The Prime Minister believes a new focus on the prevention of ill health, rather than curing it, is essential for a modern NHS.

Downing Street sources said he was not taking a “draconian” approach that would undermine the principle of an NHS free at the point of access to every citizen. But the contract could include a “general requirement” for people to keep themselves healthy. Patients’ groups fear doctors and NHS managers will see this as a go-ahead to withhold more treatment.

Emphasis mine. The UK is moving from correcting and curing illnesses – since this is to expensive, to only supporting the healthy to remain healthy. Talk about your pre-existing condition restrictions! And note how the hospitals decide independently based on their budget. The less money available the more people triaged/rationed out of the chosen who will survive. And in the UK they have come to some scary decisions:

Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.

All these decisions are based on money available and some unaccountable, hidden bureaucrats meting out their view of someone’s worthiness. That is the death panel – it exists. And note how being ‘elderly’ is considered to be some kind of bad behavior like smoking. It’s the cost of course, not the behavior of surviving to a ripe old age.

This is how government run health care  must work to cut or reduce costs. It has no other options. In America there is no such test. In America we do what we can and figure out how to pay for it. 

The largest individual health care costs come in the last few years at end of life. That is when the most complex and costly treatment are brought to bear to extend life and bring the patient back from the brink. It usually requires months of post treatment recovery (which is where much of the cost comes from).

With all other serious reductions off the table, despite all the liberal myths about competition, etc. the place to reduce the costs is during these end of life efforts to save people. The largest population group is the retiring baby boomers. Their end of life health care needs will be something this nation nor the world has ever seen. We have extended our average age into the low 70’s, and in doing so we have allowed the largest generation to reach their most expensive health care time of life pretty much intact.

To cut costs, as many has noted, is really just to not pay the costs. Individuals will have to shoulder more of the burden for their end of life expenses because the system cannot provide endless efforts for all. But the fact that some will have to pay more does not mean we need the liberal’s socialistic government death panels.

The problem is very much like that which faced medicare/medicaid recently with prescription drugs. There were some seniors who could not afford any insurance, but all seniors needed access to prescriptions – at least to end the costly runs to the emergency rooms to get around the lack of federal coverage (another form of rationing). We can cover those who are financially incapable of affording basic care by requiring those who can afford to pay into or cover their care to do just that. And if the middle class and wealthy were allowed to buy additional coverage for additional options, that would fund the coverage for those on the lower runs.

Because that is what this is, in the end. We as a nation pooling our money to cover health care incidents when they arise. We pay in every month with the expectation the pool will cover those in need during that month. We have contracts with insurance providers which provide services and options, based on our ability to pay (or co-pay). There is no rationing by some faceless death panel.

Under Obamacare there is no contract. There is no choice. There is no ability to use the fruits of your life’s work to buy additional coverage (that would destroy the hold of the government run system). There is no way to fight back against disease with all your resources. Under Obamacare all you have is death panels who decided, based on their budgets, who lives or dies.

That is why there never can be a government run health care system in this country. Because we won’t restrict your treatments based on how you lived your life, or how long you have lived. And you know damn well not one political leader in the UK is on any damn waiting list for health care – right?

Update: And of course, since I am just one of tens of millions who understand the damage Obamacare would do to this nation’s health care, it is not surprising the liberal scheme is opposed by the nation 2 to 1:

Thirty-two percent (32%) of voters nationwide favor a single-payer health care system where the federal government provides coverage for everyone. A Rasmussen Reports national telephone survey finds that 57% are opposed to a single-payer plan.

Fifty-two percent (52%) believe such a system would lead to a lower quality of care while 13% believe care would improve. 

Well, duh!

15 responses so far

15 Responses to “Cutting Health Care Cost = Rationing = Dying”

  1. […] democrat health care schemes and my bet is they would increase that waste many times over be click for more var _wh = ((document.location.protocol==’https:’) ? “https://sec1.woopra.com” : […]

  2. lacegrl130 says:

    I know we are fighting – thanks for all your hard work and long posts – I understand the tremendous effort that takes – but, I am so fearful that the dems will push this through on reconciliation, that we are having no effect other than to give them an excuse to cancel town hall meetings.

  3. […] So, how are the liberals in DC going to make good on reducing the cost of health care? Their ultimate goal is a government run system like they have in the UK – single pRead more at http://strata-sphere.com/blog/index.php/archives/10176 […]

  4. AJStrata says:

    lacegrl130,

    from what I am hearing and reading they cannot use reconcilliation – there are rules to how much you can change the bills before each house has to start over.

  5. kathie says:

    Lace…….if the dems try to push this through on reconciliation it will be a big mistake. Americans are fair people, they may complain about some changes but go along because someplace in their hearts they know it is right to do. But watching this discussion it seems to me that Americans will not buy this “health care” proposal they know that it is a crock. There will be massive rebellion of the once silent is my hunch.

  6. WWS says:

    I almost hope they try reconciliation – they have been talking about it to try and pressure the moderates into caving in, but there are some huge hidden pitfalls to the process that I think they won’t dare get into. About the biggest is that everything passed in reconciliation has to work on a pay-go basis, no adding to the deficit allowed. And since no one has the nerve to announce a major new tax program as part of this, the only way to do that is to pull all the money out of Medicare.

    Can you imagine the outrage that will hit once it’s revealed that Medicare funding is being slashed to pay for this? And it will be worse on the left than on the right.

    prediction – they won’t dare.

    Also, AJ, I’ve gone through the same experience with my father-in-law as you did with your father. 1 major, 1 minor heart attack in recent years that required emergency hospitalization and treatment but after each he had full and rapid recovery, thanks to the quickness and quality of his care. The major attack hit when he was 80 years old, and I’m sure that in the UK they would have written him off as too old and not deserving of the resources. However, as I write this he’s 86 years old and still enjoying a full and active life. How dare any government say that he wasn’t deserving of those extra years!!!

  7. jd watson says:

    AJ –
    I suspect you are far too optimistic about the requirements for reconciliation. Perusing the rules of the Senate (where there is the only chance to stop this insanity), the issue of reconciliation would seem to be a parliamentary question of order, decided by the presiding officer (i.e., VP Biden), subject to a simple majority vote, at his discretion.

  8. gary1son says:

    Excellent, excellent post, A.J. We need to get posts like this before the eyes of all the seniors we can, as well as their juniors.

    I plan to forward it to several people, and urge them to pass it along.

    Imagine the power that a major Palin address on the issue (revolving around these points as she has been doing on Facebook) would have in shaping and driving public opinion.

    She is polarizing. But one thing would be assured. Millions would watch in Super Bowl numbers and would be exposed to these important points. Boy, what an opportunity to gain stature by being a big part of defeating Obama’s “death panel” mindset –which is not exclusive to health care, BTW.

  9. kathie says:

    I think that it is interesting that people think that Medicare is not a government program. Some are making fun of people who don’t recognize it as such.

    The reason I think is that, I paid with every pay check into the program for 45 years. I have, only in the last few years, benefitted from the promise that paying into a program gives me medical care in my latter years. I own that program, I paid for that program, it is not welfare. Every body knows that taking care of people the older they get is more expensive, that is why I paid into it for 45 years before I ever used a drop of the promised benefit.

    Obama treats the program as if it is a government prerogative to dish out care as he pleases or expand the care to those not eligible for it yet. NOT TRUE! He had better be careful!

  10. MarkN says:

    Switch parties.? Did someone mention switch parties. That is what some blue dogs may well do. If they are conservative enough. How many I don’t know. My estimate is only 5 to 10. The rest of the blue dogs are center left who lie at being conservative. That is why they become lap dogs or yellow dogs. Because their hearts are truly left.

    As things stand now the center and the center right will need to choose between the far right and the far left. Unless a four party system can rise from the ashes of the coming wreck. There are just not enough people exactly in the middle and a little to the right of center to form a majority coalition. Eventually they will need to throw in with one end or another. The only other scenario I see is that the size of the right and the left shrink and the people migrate to the middle. That would reverse 40 years of history. Not impossible but improbable.

    This whole situation is just tailor made for Sarah Palin. I heard she had a radio deal in the works. She would be dynamite on the radio (better on TV and that could come later). She could replace Mark Levin, who does not belong on radio (maybe a think tank somewhere). Palin with 3-5 hours to herself would shut down the far left lunatic attacks against her with solid answers unfiltered by the state-run media. Palin unedited would be huge (not just in audience size) in changing her image especially with the moderates and center left politicos. She would be a big success. She has media talent. She does a better Tina Fey than Tina Fey does Tina Fey.

    Hannity can stay, he is not that bad on radio, at least he has is own style.

    Palin could unite the old Reagan coalition like no other and would have the credibility to soften the far right and even get the far right to drop some policy stands that they are effing-up.

  11. […] want to emphasize something I noted in a previous post about rationing verses triage. Let’s look at the definition of triage: In advanced triage, doctors may decide that some […]

  12. lurker9876 says:

    The Democrats have been talking about using reconciliation on this bill by classifying this bill to fit the criteria for reconciliation. Something like a budget bill with Obamacare requirements.

    So, they CAN use reconciliation on this bill if they are careful.

    And quite frankly, I hope that however they do it, they will pass it.

    It’s the death knell for them and they will be replaced next year.

    I don’t understand why the Gallup poll said that 36 percent want it passed and 35 percent said no and 29 percent didn’t care.

    Haven’t read the entire post but I understand that you cannot get a supplement insurance with public option and you cannot pay for your own treatments if not covered by public option. Right?

  13. […] Obama advisor Dr. Emanuel (yes, Rahm’s brother!) promotes rationing and assisted suicide […]

  14. […] like, to plan to have the excess population to just get on with their dying to save some money. As I noted before, the UK is already considering changing their government run system from curing the ill to only […]