CROSS OF CHRIST FAITH MINISTRY

by Newt Gingrich www.humanevents.com

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 acronymNICE has decided British government-run health care will pay for oneadditional 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

TheBritish single-payer bureaucrats arrived at the price of an additionalyear of life in the same way they decide how much health care allBritish people will get, through a formula called “quality-adjustedlife years.”

That means that if you’re sick in Great Britain, governmentbureaucrats 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 theoryof how to ration health care that is troublingly reminiscent of theBritish system of “quality-adjusted life years.”

Dr. Ezekial Emanuel is a key health care advisor to President Obamaand the brother of White House Chief of Staff Rahm Emanuel. Earlierthis year, Dr. Emanuel wrote an article that advocated what he called“the complete lives system” as a method for rationing health care.  Youcan read it here.

The system advocated by Dr. Emanuel would allocate health care basedon the government’s perception of the societal worth of the patients. Accordingly, the very young and the very old would receive less caresince the former have received less societal investment and the latterhave 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 hadfew life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionatelylarge amounts of resources will be directed to young people with poorprognosis.”

When fully implemented, Dr. Emanuel’s system, in his words,“produces a priority curve on which individuals aged between roughly 15and 40 years get the most substantial chance, whereas the youngest andoldest people get chances that are attenuated.”

“Chances that are attenuated” is a nice way of saying the young andthe old are considered less worthy of health care and, under thissystem, will get less.

Once Government Becomes the Provider of Health Care, Personal Decisions Become Public Decisions

Thepoint is not that a health care rationing system like the one favoredby Dr. Emmanuel will be implemented in the United States tomorrow.

The point is that, as in the British system, once government becomesthe single payer or even the main payer of health care, what were onceintensely personal decisions become public decisions.  And as costsrise, government will look for ways to contain them.  

The inevitable result of this pressure to control costs will berationing, whether it occurs during this administration or the next. At some point, the government will be forced to deny care to those whodon’t meet the latest “quality-adjusted life years” cost-benefitanalysis.

So the decision on what treatment to pursue that once would havebeen made by you and your doctor is now made for you by a bureaucratusing a formula -- a formula to literally determine if your life isworth 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, butNICE, the health care rationing agency, wasn’t created until the late1990s as a way to control costs.

Today NICE routinely denies Britons life-prolonging drugs that aredeemed not “cost effective” -- drugs that are widely prescribed inAmerica to treat cancer, Alzheimer’s disease and other seriousconditions.

The result, studies show, is that Great Britain’s cancer survivalrates are among the worst in Europe and lag behind the United States.

In America, Rationing Begins with Comparative Effectiveness Research (CER)

Inour country, the road to dehumanizing, bureaucratic health carerationing begins with something called comparative effectivenessresearch (CER).  It sounds completely innocent.  In practice, CER meanscomparing 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 caresystem, comparative effectiveness research becomes a way to find acheaper, one-size-fits-all approach to medicine that will limit healthcare choices for patients.

But don’t just take my word for it.  Congressional Democratsincluded $1.1 billion in the Stimulus Bill for CER.  Report languageexplaining the bill noted that the treatments found to be “moreexpensive” as result of the research “will no longer be prescribed” andthat “guidelines” should be developed to manage doctors.  

Congressional Democrats also killed several amendments to thecurrent health care bill that would have prevented CER from being usedto ration care.  (To learn more about the common-sense amendments tothe bill that have been blocked, click here).

The Government Has Determined You Must Take the Blue Pill

President Obama innocuously described the intended result ofcomparative effectiveness research like this:  “If there’s a blue pilland a red pill, and the blue pill is half the price of the red pill andworks just as well, why not pay half price for the thing that’s goingto make you well?”

Listen to what the President is saying here.  He’s saying that thegovernment is capable of determining which pill works best for you andshould therefore only pay for that pill.

But this one-size-fits-all approach goes against everything modernmedicine is learning about the genetics of the human body.  Differentindividuals and members of different ethnic and age groups responddifferently to treatments.  More and more, treatment of diseases likecancer is highly individualized and based on a genetic analysis of boththe patient and her disease.  Science is leading us in one directionand 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, butthe government has determined that the blue pill is what works best forits budget?  In a single payer health world, what do you do then?

Creating a Commission to do the Dirty Work

Governmentbureaucrats limiting health care choices is terribly unpopular ofcourse, which is why politicians use terms like “comparativeeffectiveness research” instead of “rationing.”

Another method Washington uses to avoid complicity in health carerationing is the creation of government boards or commissions -- likeBritain’s NICE -- to do the job for them.

President Obama has expressed his supportfor using the Medicare Payment Advisory Commission (MedPAC), acommission created to advise Congress on Medicare, to achieve costsavings under health care reform.

Because the commission’s decisions could only be over-ridden by ajoint resolution of Congress, it would be virtually unaccountable tothe people -- and nervous members of Congress could blame thecommission for unpopular decisions.

Combine this kind of a commission with the “complete lives system”advocated by White House health care advisor Dr. Ezekial Emanuel andyou end up with a government rationing board literally determiningwhich Americans should live and which should die.

Just Trust the Government

Supportersof government-run health care dismiss these worries as alarmist.  Theyargue that because their big government health care bill doesn’tovertly call for rationing, it is somehow illegitimate to talk aboutthis danger.

But it is always legitimate to consider the long-term consequencesof a government program.  By refusing to have an honest debate of thisissue -- to explore honestly the consequences of the “painful choices”that all supporters of government health care say must be made -- theirargument 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.

Your friend,