Follow the [European] Leader?

By Monica Frede


Last week, many pundits commented on the New York Times op-ed that vindicated Sarah Palin’s infamous “death panels” that drew scrutiny from Democrats and moderate Republicans during the ObamaCare debates of 2009.

See, Republicans boasted, she was right all along! Even the New York Times admits that there will be rationing. Yes, Steven Rattner did write in his op-ed that “unless we start allocating health care resources more prudently—rationing, by its proper name—the exploding cost of Medicare will swamp the federal budget.” Yes, Rattner did write that “elderly Americans are not entitled to every conceivable medical procedure or pharmaceutical.” And yes, he also stated that families that try every available treatment option to extend or improve the life of their elderly relatives are “an enormous societal cost that few other nations have been willing to bear.”

But what lies beneath his fatalistic tone, rivaling the grim appearance of the ghost of Christmas future with his grey index finger extended towards the grave, is Rattner’s abdication of American ingenuity. He admits in his column that Americans can hope for no better solution than any other country in the world has attempted within its health care system. We are not the first society to stumble down the rugged path of nationalized health care; instead, we are blindly following the lead of other ragged nations:

No one wants to lose an aging parent. And with price out of the equation, it’s natural for patients and their families to try every treatment, regardless of expense or efficacy. But that imposes an enormous societal cost that few other nations have been willing to bear. Many countries whose health care systems are regularly extolled — including Canada, Australia and New Zealand — have systems for rationing care.

Take Britain, which provides universal coverage with spending at proportionately almost half of American levels. Its National Institute for Health and Clinical Excellence uses a complex quality-adjusted life year system to put an explicit value (up to about $48,000 per year) on a treatment’s ability to extend life.

At the least, the Independent Payment Advisory Board should be allowed to offer changes in services and costs. We may shrink from such stomach-wrenching choices, but they are inescapable.


Since when should we “take Britain,” for example, when tackling such Herculean challenges? Surely we did not “take Britain” when George Washington crossed the Delaware River. Surely we did not “take Britain” when Neil Armstrong, who once said, “I believe the good Lord gave us finite number of heartbeats and I’ll be damned if I’m going to use up mine running up and down a street,” became the first man to set foot on the moon. And we did not “take Britain” when Steve Jobs envisioned a phone that would weigh less than a roll of quarters, pinpoint your exact geographic location, list the top-rated restaurants within a three mile radius of your vehicle, all while carrying on a conversation.

But if you are a deconstructionist, you certainly would “take Britain.” If you believe American history is a story of woeful, harmful people with no significance, value or purpose, then finding a cure for an insolvent healthcare system which treats all patients equally while providing exceptional care is too large of a mountain to climb.

Only a deconstructionist believes the Independent Payment Advisory Board necessarily plays the part of savior and grim reaper, and, in Rattner’s view, should be allowed to offer changes to services and costs.

The best we can hope for is a board of 15 “advisors”— who can only be repealed with a three-fifths majority in both chambers during a seven-month window in the year 2017— prescribing end of life decisions to our trained, educated neurosurgeons? They should be allowed to limit or restrict health services to American citizens because searching for an alternative solution is hopeless?



This, I believe, is the argument we will hear from the left moving forwardhope and change dwindled down to hopeless changes. Even though the government is too big to fail, you are not. You are expendable.

Let’s not forget that with the elderly population growing rapidly, even if cost increases for each beneficiary can be contained, Medicare would still claim a rising share of the American economy.

Medicare needs to take a cue from Willie Sutton, who reportedly said he robbed banks because that’s where the money was. The big money in Medicare is not to be found in Mr. Ryan’s competition or Mr. Obama’s innovation, but in reducing the cost of treating people in the last year of life, which consumes more than a quarter of the program’s budget.

Our President famously stated that he believes in American Exceptionalism, just as the Brits believe in British exceptionalism and the Greeks believe in Greek exceptionalism (insert images of chaos and anarchy roaming the cobblestone streets of Athens).

I’m glad George Washington never subscribed to this monolithic image of America’s future— or we would know Britain’s universal healthcare system sixty-seven years intimately. But then again, we once had a President who believed that “someday, following the example of the United States of America, there will be a United States of Europe.”