President Obama has launched an all-out attack on the insurance companies in his new healthcare plan. Unfortunately for Americans, the private insurance industry is the last thing standing between us and socialized medicine — and as a result, socialism.
In his first major legislation, the American Recovery and Reinvestment Act of 2009 — i.e. the stimulus bill — President Obama created a couple of agencies that might have raised some eyebrows if anyone in Washington had read the bill before voting on it.
One, the Office of the National Coordinator for Health Information Technology, is supposed to help facilitate the computerization of medical records. One mandate of the Office, though, is to provide “appropriate information to help guide medical decisions at the time and place of care.”
The other, the Federal Coordinating Council for Comparative Effectiveness Research, has a seemingly innocuous agenda:
SEC. 804. FEDERAL COORDINATING COUNCIL FOR COMPARATIVE
EFFECTIVENESS RESEARCH. (a) ESTABLISHMENT.—There is hereby
established a Federal Coordinating Council for Comparative
Effectiveness Research (in this section referred to as the ‘‘Council’’).
(b) PURPOSE.—The Council shall foster optimum coordination
of comparative effectiveness and related health services research
conducted or supported by relevant Federal departments and agencies,
with the goal of reducing duplicative efforts and encouraging
coordinated and complementary use of resources.
(c) DUTIES.—The Council shall—
(1) assist the offices and agencies of the Federal Government,
including the Departments of Health and Human Services,
Veterans Affairs, and Defense, and other Federal departments
or agencies, to coordinate the conduct or support of
comparative effectiveness and related health services research;
and
(2) advise the President and Congress on—
(A) strategies with respect to the infrastructure needs
of comparative effectiveness research within the Federal
Government; and
(B) organizational expenditures for comparative
effectiveness research
So, what is comparative effectiveness research? It’s a framework for determining what works and what doesn’t, and leans heavily on Health Technology Assessment (HTA) to allow policy-makers and those directly involved in healthcare to speak a common language. Liken it to a hospital administrator trying to figure out if an uninsured patient will receive a procedure or not — the doctor explains the procedures needed, and the administrator figures out whether the benefit to the patient is worth the cost to the hospital.
In HTA, the predominant language spoken is Quality-Adjusted Life Years (QALY):
The QALY is based on the number of years of life that would be added by the intervention. Each year in perfect health is assigned the value of 1.0 down to a value of 0.0 for death. If the extra years would not be lived in full health, for example if the patient would lose a limb, or be blind or have to use a wheelchair, then the extra life-years are given a value between 0 and 1 to account for this. The QALY is used in cost-utility analysis to calculate the ratio of cost to QALYs saved for a particular health care intervention. This is then used to allocate healthcare resources, with an intervention with a lower cost to QALY saved ratio being preferred over an intervention with a higher ratio. This method is controversial because it means that some people will not receive treatment as it is calculated that cost of the intervention is not warranted by the benefit to their quality of life. However, its supporters argue that since health care resources are inevitably limited, this method enables them to be allocated in the way that is approximately optimal for society, including most patients.
In short, if a liver transplant would give a patient an extra 30 years of life, it is considered a good use of an organ. However, if the recipient is blind and in a wheelchair, his QALY might be reduced to 5 or 10 years. A bureaucratic system provides “quantitative proof” that the liver should go to a more healthy candidate who won’t live as long, but will live a better quality of life. That’s rationed healthcare at its best, and is surely where the United States is heading if and when we add 46 million uninsured Americans to the already overloaded healthcare system.
Now consider the areas that HTA covers:
Any intervention that may be used to promote health, to prevent, diagnose or treat disease or for rehabilitation or long-term care. This includes the pharmaceuticals, devices, procedures and organizational systems used in health care.
Finally, take a look at President Obama’s proposed healthcare plan. Despite the fact that insurance companies have averaged only about a 4% return on investment over the past four years — in the bottom third of American industries — and is battling spiraling healthcare costs, Obama wants to set up a panel that will effectively cap or deny hikes in health insurance rates. He wants insurance companies to be forced to provide insurance to people with pre-existing conditions; such plans cost insurers hundreds of millions of dollars every year. Further, he is imposing large taxes and/or free-market restrictions on the exact same pharmaceutical and device-manufacturing companies that are “examined” under HTA.
The framework for universal healthcare was laid in the stimulus bill. Government has access to your records and the records of people against whom you will compete, for lack of a better word, for rationed healthcare. They are laying in place the QALY system to determine who will receive treatment and who will not.
The final brick in the implementation of Obama’s plan to socialize medicine is being blocked by those evil private insurance companies, pharmaceutical companies, and medical device manufacturers. Once the government bankrupts these private sectors and jumps in with a “bailout,” they will have regulatory control over what medicines, devices, procedures, and care you receive.
(And in case anyone still wants to deny that Obama is a socialist, just read the bottom of the second page of the letter he sent to Congress accompanying his FY2011 budget):
“In the aftermath of this crisis, what is clear is that we cannot simply go back to business as usual. We cannot go back to an economy that yielded cycle after cycle of speculative booms and painful busts.”
Obama is a Harvard-educated guy. He knows that an economic cycle isn’t that May was good, but July was bad.
He’s talking about the Roaring 20s, the Great Depression, the stock market boom of the 50s, the 1973-1974 crash that saw stock values fall 48%, the great years under Reagan-Bush-Clinton, the stock crash after 9/11, the meteoric rise to the Dow peaking above 14,000 under Bush in 2007, and the precipitous decline after the bank bailouts and TARP. He’s talking about long-term, generational cycles, and that it’s “clear” that we “cannot go back” to that kind of economy.
In other words, say goodbye to capitalism and hello to socialism.