Free Markets, Free People

rationing


The “right” to health care vs. the right to earn a living

More fallout from the ObamaCare monstrosity.  Reality begins to set in with a vengeance:

Want an appointment with kidney specialist Adam Weinstein of Easton, Md.? If you’re a senior covered by Medicare, the wait is eight weeks.

How about a checkup from geriatric specialist Michael Trahos? Expect to see him every six months: The Alexandria-based doctor has been limiting most of his Medicare patients to twice yearly rather than the quarterly checkups he considers ideal for the elderly. Still, at least he’ll see you. Top-ranked primary care doctor Linda Yau is one of three physicians with the District’s Foxhall Internists group who recently announced they will no longer be accepting Medicare patients.

"It’s not easy. But you realize you either do this or you don’t stay in business," she said.

For those slow on the uptake – when limited resources meet unlimited need, rationing is going to take place regardless of whether one wants it or likes it.  Rationing can take effect in many ways.  Two of the most common are by price and by availability (or a combination of both). 

Declaring everyone is “entitled” to health care doesn’t make it more affordable or available.  Because its availability doesn’t increase automatically on such declarations.  And that was the fly in the ObamaCare promise from the very beginning.   Then add in the absurd claim that you can get more for less and you’re where we are now with doctors and Medicare patients.

Reality is a harsh mistress.  Reality says that a person will do what is necessary in the business world to keep their business going.  We’ve seen that with the drop in employment during this recession as businesses cut back on headcount to survive it.  The same goes with the business mix of paying customers any business has.   If it takes a certain amount a month to maintain your practice, you have to ensure that is covered along with whatever profit (read salary) you want for yourself. The most common way a business does that, besides cutting expenses, is to raise prices.

But in health care you can’t really do that.  So?  So instead you change your business mix.  You begin to refuse to see those who pay the least in favor of those who pay the most, i.e. less Medicare patients and more private insurance patients.

If you’re a doctor, you spent 10 years of your life getting to the position you now hold and even more years building your practice.  You are, in fact, a small business owner who employs a good number of health care workers both directly and indirectly.

If however 40% of those you see are Medicare patients and those patient payments to doctors are being drastically reduced such that you’ll now be pulling in much less a month than you need to meet all your financial requirements, it is time to reassess the mix of patients you can afford to see.   Note the word – afford.  This is the only way a doctor can “raise prices”. 

There are those who claim that such a doctor has a responsibility to see whoever comes in the door.   In fact that doctor has many other responsibilities that preclude that – like his responsibilities to those he employs, the expense of his practice, malpractice insurance, student loan payback, etc.  He can’t see the first patient until all of those things are paid for.  And then he has to maintain his or her practice (thus the overhead) at a certain level to meet the needs/demands of the patients he does see. 

So when he looks at his mix of patients, he has to make a decision, doesn’t he?  And, as you see in the cite, many are beginning to make that decision.  He has to get that revenue stream back up to the level at which he can at least cover minimum needed to sustain his practice at a level he deems necessary.

Among the top points of contention is the complaint by doctors that Medicare’s payment rate has not kept pace with the growing cost of running a medical practice. As measured by the government’s Medicare Economic Index, those expenses rose 18 percent from 2000 to 2008. During the same period, Medicare’s physician fees rose 5 percent.

"Physicians are having to make really gut-wrenching decisions about whether they can afford to see as many Medicare patients," said Cecil Wilson, president of the American Medical Association.

But statistics also suggest many doctors have more than made up for the erosion in the value of their Medicare fees by dramatically increasing the volume of services they provide – performing not just a greater number of tests and procedures, but also more complex versions that allow them to charge Medicare more money.

From 2000 to 2008, the volume of services per Medicare patient rose 42 percent. Some of this was because of the increasing availability of sophisticated treatments that undoubtedly save lives. Some was because of doctors practicing "defensive medicine" – ordering every conceivable test to shield themselves from malpractice lawsuits down the line.

Of course they practice preventive medicine because Congress has adamantly refused to address tort reform, so, in many practices the largest expense incurred per year is malpractice insurance.  And naturally that constant threat drives the medicine to some extent.  Additionally it is human nature to try to get what you believe your services are worth if you’re going to render them. 

Instead we have  an outside entity arbitrarily declaring what they’re worth.  It is has now  gotten to the point that providers have to make some decisions because they can no longer operate at the level they desire too with the payment structure in effect.  And, as can be seen, they are making those decisions.

Which brings us back to the point that was made on this blog many times before when the promise of health care for all at lower cost kept being thrown around.  You can’t have it both ways.  The fact that there is now going to be more demand on a finite product means that rationing is somehow going to exist.  The fact that you have insurance obviously doesn’t guarantee you a doctor. 

Of course the reaction to these decisions is predictable as well:

Still, even if primary-care doctors had to rely exclusively on Medicare’s lower payment rates their incomes would only drop about 9 percent, according to a recent study co-authored by Berenson, who is also a fellow at the non-partisan Urban Institute.

"The argument that doctors literally can’t afford to feed their kids [if they take Medicare's rates] is absurd," said Berenson. "It’s just that doctors have gotten used to a certain income and lifestyle."

Got the implied argument there?  Whatever the income and lifestyle, they’ll just have to get over it and go along with the arbitrary price fixing government decides on. They’re probably among the “undeserving rich” Krugman was talking about below.  Oh, and note that a 9% drop in income also means a commensurate drop in the amount of overhead the office can afford – headcount in other words.  And that may mean poorer treatment.

You don’t get to decide what you’ll charge and let the market either reward or punish you for doing so. Oh, no.  The government will decide on what is acceptable, private insurance will go along because it is worth their while (they may not match the cost but they’ll lower their payout because the government has lowered its payout), malpractice insurance will most likely rise (you can’t do a better job with less staff and less time) and there you are, captaining a sinking ship.

Of course the reaction  being documented here is an immediate reaction to a flawed policy.  It is as natural as self-defense, because in a business sense, that’s precisely what it is.  Health care is a business, not a “right”.  And this is how businesses react to such intrusions in the market that could conceivably kill their chance at survival.

Long term the result will be even worse and more drastic.  And we’ve begun to see it already.  With all the turmoil and cost cutting in the health care industry, fewer and fewer are choosing it as a career path.  People like Berenson can sneer at doctor’s concerns now, but as almost every medical association out there has noted, fewer and fewer people are entering the profession.  And that’s across the board.  It seems, for whatever reason, our social engineers simply don’t understand economic basics and constantly and consistently dismiss them with disastrous results. 

Incentive is a wonderful motivator that has brought us all sorts of innovation and a better life.  Destroy that and you destroy motivation and the desire to excel.  That’s precisely what is happening here – with predictable results.

~McQ


Death Panels? What death panels?

Rationing?  Never.  “Death panels?”  No such thing! When government runs your health care they won’t act like those evil insurance companies that deny you treatment.  Wasn’t that the promise?

A controversial new policy by the Arizona Health Care Cost Containment System depriving hepatitis C patients coverage for liver transplants is effectively a death sentence that, left unchecked, could have far-reaching consequences for millions of Americans afflicted with chronic viral hepatitis, the National Viral Hepatitis Roundtable (NVHR) said today.  

The new coverage exclusion governing liver transplants took effect Friday as part of broader Medicaid coverage changes made by the state of Arizona in response to budgetary pressures.

I’m not here to call for unlimited spending or every procedure to be okayed. I understand budget constraints.

However, critics have said that the sort of rationing and denial of care that is demonstrated above was an inevitable outcome of government taking over health care.  Those that referred to this type rationing as “death panels” were denigrated and demonized. 

Now I understand that while Medicaid is a government run program, it is a state run program that is subsidized by the Federal government to some extent.

But ObamaCare has pushed new mandates down on the states by expanding coverage and the states are faced with making literal life and death decisions concerning the affordability of care for those in their system.  This is only one of many “death panel” decisions that are going to eventually effect the lives of millions.

All foretold and inevitable. 

In other ObamaCare news more of the foretold and inevitable:

3M Co., citing new federal health laws, said Monday it won’t cover retirees with its corporate health-insurance plan starting in 2013.

Instead, the company will direct retirees to Medicare-backed insurance programs, and will provide reimbursement for that coverage. It’ll also reimburse retirees who are too young for Medicare; the company didn’t provide further details.

Apparently after reviewing the law 3M concluded that even with a subsidy offered in the legislation, it was more costly to keep the coverage than abandon it:

Maplewood-based 3M (NYSE: MMM) is one of the first large companies to indicate that it won’t tap a large federal-government reimbursement program created by Congress as part of the health insurance reform package, The Wall Street Journal reported. The rebate program was meant to encourage employers to keep in place their health-insurance plans for retirees.

Obviously, by 3M’s reading of the law, the “federal-government reimbursement program” didn’t offset the cost of keeping retirees in the system.  As you see more and more of these stories pop up – and you will – you have to begin to wonder if this isn’t a deficiency by ignorance or design – a bug or a feature.

As this goes on, you can’t help but feel it is more the latter than the former as such actions by companies move us closer and closer to a single payer system.  And when that inevitably happens, it will be characterized as the fault of greedy corporations and, of course, “market failure”.

Fair warning.

(HT: Rod F)

~McQ


Government health care’s inevitable fate

Canada’s health care system is in deep trouble financially. So it should come as no surprise that the British NHS is as well. It is simply in the process of proving correct Margaret Thatcher, who said, “the trouble with socialism you eventually run out of other people’s money”.

The Brits ran out of “other people’s money” quite some time ago (as is the US as debt and deficit figues show) and their social structures are existing on debt. And the NHS, the celebrated “single-payer” government run system in place since right after WW II, is failing:

Jeff Taylor of the Economic Voice clarified the problem when he wrote last week that “the U.K. is broke.”

“Our whole society and way of life is now built on the shaky foundation of debt,” he writes in response to the NHS cuts. “Our hospitals, schools, armed forces, police, prisons and social services are founded on debt. In truth we have not yet paid for the operations that have already taken place.”

The NHS is planning on extensive rationing of surgery. The service is looking at eliminating literally millions – with an “m” – of surgical procedures because it simply cannot afford them. Representative of those procedures which will no longer be available are hip replacements for obese patients, some operations for hernias and gallstones, and treatments for varicose veins, ear and nose problems, and cataract surgery.

The intent is to “save” 29 billion by telling patients in need of those procedures “no”.

Rationing, pure and simple – as promised. However, it is government deciding what you can or can’t have, regardless of your preference or need. This is indeed the ultimate outcome of handing things such as health care over to any third party. And it is especially a problem when “cost containment” takes precedence over health care.

That is precisely the mandate government here has assumed with its legislative charter to “cut costs” in the health care business. With that as a priority, and given the structure of the new law, an almost impossible priority to fulfill, the same outcome is almost guaranteed here. With cost containment driving the train, shortages are inevitable. And what those shortages mean, in concrete terms, is precisely what the NHS is planning on doing – denying patients health care.

The inevitable shape of things to come.

~McQ


Some thoughts on a changing health care scene

Don Surber reminded me yesterday in something he wrote that the thing that is being forgotten in all of this is the premise that health care reform is based upon is

cost containment.  Or, as Surber puts it:

Government-run health care is about saving money, not lives.

Think back and think it through. What government is promising is insurance for all (more cost) and lower cost insurance plans (the repeated Obama promise was $2,500 per family on their premium – don’t forget Joe Biden’s promise that this bill “controls” the insurance companies). Those seem to conflict, but in reality, they can be accomplished even though you’re very likely not to like the result.

How? Severe rationing and imposed cost controls. Rationing would be accomplished by increased wait times, outright denials or limited care. Doctor visits would have to be shorter and shorter (reimbursement rates would encourage if not demand that). And of course limiting testing and the use of high-cost, high-tech diagnostic machinery is a given.

But won’t doctors and other health care providers have the choice of whether or not to take patients under such plans? Well, initially yes. However, it stands to reason that at some point, when large numbers of the newly insured can’t find a health care provider because of the constraints on care and reimbursement rates their insurance provides, that government will feel the necessity to step in – again.

If it can order individuals to buy insurance on pain of fine, what is to stop it from ordering doctors and other health care providers to take anyone with insurance, regardless of the reimbursement rates? It certainly doesn’t blink an eye at ordering insurance companies to take anyone with a pre-existing condition.  So at the moment I can’t think of a thing that would stop that sort of a law (that’s not an argument for its constitutionality, it’s simply a recognition of reality). My guess is Congress certainly believes it has that sort of power right now. We can only hope the courts decide otherwise. The whole point, of course, is that having insurance doesn’t guarantee health care or access to a doctor. And low reimbursement rates will guarantee they won’t have access.  The government is going to want to “fix” that.

If government-run health care is about saving money, not lives then one of the targets of any effort to “save money” is going to be high cost treatments. Many of the highest costs in health care come when? In the last months of life, of course. We’ve been told that 500 billion has to come out of the Medicare budget to help us save money on health care overall. And don’t forget, Medicare issues more denials of care than any other insurance provider. I don’t think it should take a particularly intelligent person to do a little dot connecting here.

That brings us back to the providers themselves. What will be their reaction to the primary push for cost control/containment?

Well, don’t forget, almost every practice out there is a small business. And if they make over $250,000 (and the vast majority do) they’re going to first and foremost be taxed at a higher rate. You know, because they’re “rich”. That will probably mean fewer staff, longer waits, less care. Or, by the simple means of taxing the practice, the government will manage to get between you and your doctor by changing how your care is delivered.

And, you have to wonder, how long will the better doctors put up with this before they decide to retire or find something else to do? I’m guessing this will be the first sector in the economy where Atlas will do some shrugging. I think in the next few years you’re going to see medical school enrollments drop, active government recruiting (subsidized education for x years of service) of students to go into the medical field as well as off-shore recruiting as well. Net result – the brightest and best will no longer be a characteristic of our medical community.

Those are a few of my thoughts on the future based on this law. Things may change, but like the CBO, I can only take a look at the static picture and make my assumptions based on that. I don’t see how this all accomplishes what the government has promised unless there are some pretty severe cuts in care and service and a lot of rationing through denial of service or claims. I don’t see how it all works as the government has promised unless all health care providers are forced to take anyone with insurance regardless of the reimbursement rates. That leads me to believe that government will try that in an attempt to accomplish it’s stated goal of bending the cost curve down. And at that point, my guess is health care providers rebel, many doctors quit and massive litigation begins.

For those of you hopping around celebrating this travesty today, is that what you expected or want?

~McQ


About That Claim That Doctors Support Obamacare

The Democrats have made the claim that the AMA, doctors and nurses all support the Obama plan for health care reform. But if a new IBD/TIPP poll is to believed, it is possible a large number of doctors would leave their practice if the present version of health care reform was passed:

Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

And, like most Americans, a majority of doctors polled found the administration claims to be unbelievable:

72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost.

Additionally:

Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration’s claims that doctors are part of an “unprecedented coalition” supporting a medical overhaul.

Another fact that should be taken into consideration when the administration claims that the AMA supports their plan, presently the AMA only represents 18% of American physicians.

Four of nine doctors, or 45%, said they “would consider leaving their practice or taking an early retirement” if Congress passes the plan the Democratic majority and White House have in mind.

In 2006, there were 800,000 doctors practicing in the US. A 45% reduction would leave 440,000 doctors to treat the present insured population plus the 40 million more the administration plans to add.

I’ll leave it to you to do the math, but if you can figure out how fewer physicians and more patients equals less cost, better care and no changes in the health care you enjoy today, I’d be interested to hear it.

If the answer is “rationing care”, I believe we’ve been saying that for quite some time, haven’t we?

~McQ


The Health Care Presser

I loved a tweet that Jon Henke sent out last night during the Obama health care press conference.  It had me laughing – “Shorter Obama: you’re either with us or against us”.

In reality the press conference was the retelling of the same old nonsense. We’re going to expand the insurance system, require everyone be taken, no pre-existing conditions, no dropping you or denial of service. We’ll pay for it by finding some savings in waste, fraud and abuse, do health care delivery better than anyone else has ever done it, tax the rich and do it all – every bit of it – cheaper than it’s being done now, because we’re the government and we’re the experts in efficiency.

Tell me that wasn’t the crux of the presser?  Anyone left wondering why the majority of Americans are skeptical?

And of course we had the usual canards out there. The claim that preventive medicine is cheaper than medicine as it is being practiced now. Take a moment to read this post by a doctor who lays out the con in minute detail. Here’s another view. Here’s a fact no one seems willing to deal with – the vast majority of all health care costs come in the last 6 months of life.  No one has beaten death yet.  Ergo that fact isn’t going to change unless the entity with the money refuses to pay up.  So while preventive care may extend life, the cost of preventive care is more expensive and the end result remains the same.

As for paying for it,  the whole appeal, of course, was to give the allusion to the middle class that he and the Dems were all for soaking the rich to cover the cost, even talking about how taxing millionaires met his “principle” on that.

But as Mickey Kaus points out, you have to listen carefully:

I don’t want that final one-third of the cost of health care to be completely shouldered on the backs of middle-class families who are already struggling in a difficult economy. And so if I see a proposal that is primarily funded through taxing middle-class families, I’m going to be opposed to that …

Kaus points out that those two words, in “Wash-speak” mean he’s open to a middle-class tax to pay for the “new” and “improved” health care (49% isn’t “primarily”, right?).

And then there’s the dawning understanding around much of the country that this isn’t about reforming health insurance at all (something that might be appealing to most).  It is about a fundamental change in how health care is delivered. As the Republicans have begun saying, it is “experimenting” with your health care.

Can I guarantee that there are going to be no changes in the health-care delivery system? No. The whole point of this is to try to encourage changes that work for the American people and make them healthier. And the government already is making some of these decisions. More importantly, insurance companies right now are making those decisions. And part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works. Because that’s not how it’s working right now. That’s not–that’s not how it’s working right now.

Yes the government is already making some of those decisions. And the unfunded liabilities of the government system threaten to bankrupt us.

But the point remains that peppered all through the statement and answers was the phrase “health care delivery”.  That is one of the things driving down the approval ratings on the legislation.  Its one thing to say, “hey we’re going to eliminate pre-existing conditions, portability issues and denial of service while making sure everyone has insurance”.   It is an entirely different thing to say “we’re going to tinker with and change the way your health care is delivered”.

Now suddenly the government is in territory few want it in.  And that’s the overreach that Obama and the Democrats have committed that is driving the health care legislation approval numbers down.  Which gets us into the politics of this.

Obama said “this isn’t about me”.  But in fact it is all about him and maintaining his credibility.  But his problem, as usual, is he’s outsourced his signature agenda item to Congress.  Peter Wehner discusses the result:

On virtually every important issue — from the stimulus package, to cap-and-trade, to health care, to taxes, and more — Obama is ceding the agenda to the barons on Capitol Hill. And they will lead him over a cliff.

Why this is taking place is hard to know. It may be that Obama and Company are over-learning the lessons of the Clinton and Carter years, when relations with Democrats on the Hill were strained. It may be that Obama doesn’t like to immerse himself in the nitty-gritty of policy and is more comfortable deferring to those who do. It may be that the liberals on the Hill actually reflect what Obama himself — whose record as a legislator was, after all, markedly liberal — favors. It may be that Obama’s lack of experience is now showing through. Or it might be a combination of all four.

Regardless of the cause, the result will be damaging, and maybe even debilitating, to the Obama administration. All the campaign’s promises — about practicing a new brand of politics, finding middle ground, embodying hope and change — seem so old, so dated, and so cynical. Obama is turning out to be Salesman-in-Chief. But what he’s trying to peddle — an unusually liberal agenda and legislation that ranges from ineffective to downright harmful and reflects the desires of leading Congressional Democrats rather than the needs of the country — ain’t selling.

No, it’s not, thus the reason for the presser. As I pointed out yesterday, it is obvious at points he has no idea what is or isn’t in the bill. But what he does have a firm grasp on are his talking points, even if, as the days and weeks go by, they’re shot away or, at best, left hanging tattered and limp.

Speaking of politics, I love the attempt to take on the Republicans as the bad guys (one of the main Democratic talking points for days has been that the Republicans have brought no alternative to the table) and then this:

So, for example, in the HELP committee in the Senate, 160 Republican amendments were adopted into that bill, because they’ve got good ideas to contribute.

I’m not noting this with particular approval, I’m simply noting how this gives lie to the talking point.

To conclude, for anyone who has looked into the issue and followed the debate, such that is has been, Obama’s performance was anything but impressive. It was a mix of tired talking points and a con job – careful rhetoric that implied one thing while really saying something else (the middle-class tax increase being a perfect example).

But that doesn’t mean that some form of health care legislation won’t pass. I think, unfortunately, it will. And that is all about him and politics and he knows it. So do the Democrats. Clinton, Reagan, and GW Bush all passed their signature legislation before the first August recess in their first term. That isn’t going to happen in Barack Obama’s case. But he and the Democrats know that something they can call health care reform must pass or, as Obama is reported to have said, it will destroy his presidency.

To our eternal sorrow the fact that he’s right means the Democrats will do whatever is necessary to pass something to maintain his viability.

~McQ


“Health Care” – Government Will Decide When Enough Is Enough

As you may or may not know, I just sent the last week touring the houses of Thomas Jefferson, James Madison and James Monroe – three of this nation’s founding fathers. So when I glanced through the following interview with Barack Obama I tried to picture any of these three men ever contemplating this question or a role for government in the context of the question and frankly, it’s unimaginable.

The only vision I could even begin to imagine is the three of them looking on sadly and shaking their heads “no” in unison as they tried to grasp the size of government and the depth of its intrusion into the lives of citizens the questions and answers indicated. I’m sure they’d also be trying to figure out where it all went wrong. The questions have to do with “end of life care”:

Q:…where it’s $20,000 for an extra week of life.

THE PRESIDENT: Exactly. And I just recently went through this. I mean, I’ve told this story, maybe not publicly, but when my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.

So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.

And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart.

I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.

“…society making those decisions to give my grandmother … a hip replacment?” Above that he points to a doctor giving who that choice?

His grandmother.

Below that who is Obama talking about making that decision or having that choice? Well it isn’t his grandmother. And although he uses the term ‘society’, he means government. Note he says that if someone had told him no he’d be upset, but he’s setting up the table to be ‘upset’. This is an old Obama trick – acknowledge the downside in a very personal way while still pushing for that downside.

Q: And it’s going to be hard for people who don’t have the option of paying for it.

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

Anyone who hasn’t quite figured out the rationing model Obama is talking about with his answers to these two questions needs to take a remedial reading course. Anyone – where does he see the opportunity to “cut costs” in the medical field?

And, how will he do it. Unless you’re still hungover from celebrating Guinesses’ 250th birthday, he is talking about denial of service especially to the elderly. Government will determine whether or not you’re worth that $20,000 operation. And the “moral issue” he’s talking about is all wrapped up in egalitarianism. What he’s implying may be “immoral” is allowing those who can pay access to the service while those who can’t pay (and for whom government won’t pay) are denied it.

Again, contemplate the model Obama talks about – reducing the cost of health care – and tell me which way that “moral issue” would be decided? Got the money? Too bad – it would be “immoral” to let you buy the service others are denied.

Q: So how do you — how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

What a question. The assumption is swallowed whole. Where was the question “what if ‘we’ don’t want others making those decisions?”

And apparently you guys in fly-over country are too emotionally involved to make that sort of a decision through “normal political channels” so government have some unelected outside group develop the “guidance.” Only the elite can answer these questions properly.

Three questions, stunning in their implications. Three answers which should make the skin of all lovers of liberty crawl. I’m again left imagining Jefferson, Madison and Monroe listening in on this with unbelieving looks of horror on their faces. The irony is, their opposition to this incredible power grab by government would again leave them in the category of “radical”.

~McQ


Health Care Is Next – Will We Heed The Warnings?

As the Obama administration prepares to hold a health care summit, a reminder about involving the government too deeply in your health care decisions:

Thousands of patients with terminal cancer were dealt a blow last night after a decision was made to deny them life prolonging drugs. 

The Government’s rationing body said two drugs for advanced breast cancer and a rare form of stomach cancer were too expensive for the NHS. 

The National Institute for Health and Clinical Excellence is expected to confirm guidance in the next few weeks that will effectively ban their use. 

Note the bold term. Government rationing body. Doesn’t matter what you want or need or are even willing to pay for, does it? Denied with no recourse except to get on an airplane, fly to the US and pay for it yourself … if you can afford all of that. And what if there were no US to fall back on?

When the government owns the problem, rationing will be the result. Take a look around you and tell me what you see going on economically. What do you suppose, then, will be the case if the same sort of system exists here? How can it be any different?

And a side note about unintended consequences. If you were the CEO of the drug company that developed these drugs, would such development be a priority in the future? Right now you have the relatively free market of the US to sell such products in. And as they’re used and studied, even better drugs will result. But if that market dries up because government is unwilling to pay the price for newly and expensively developed drugs, what’s the incentive for you and your company to do so?

~McQ

[HT: Below The Beltway]

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