Deadly Doctors was the title of a piece written for the New York Post by Betsy McCaughy. Her premise in talking about deadly doctors was that health care reform would lead to decision being taken out of the hands of doctors on the grounds of what is best for their patient and into the hands of bureaucrats trying to save money.
You can read her piece on deadly doctors here. The question that is really important though is is this likely to happen? Will we actually end up with health care being rationed by bureaucrats?
Rather than simply alleging that it will, or indeed that it won't, why not try to find out what actually happens in a place where they already have national government run health care? Like, say, Britain, with its National Health Service (NHS). Is health care there rationed according to a bureaucrat's measurement of costs? Are they really ending up with "deadly doctors"?
It has to be said that yes they are. Just as is being suggested for us here in the US, there is an appointed bureaucracy (no, not accountable to the public) which decides upon which treatments shall be made available, The National Institute on Clinical Excellence (or NICE as the acronym is). This organization looks at what are known as Quality Adjusted Life Years, or QUALY. They work out how many years of extra life a treatment is expected to provide to a patient and how good the quality of that life will be. 5 years in a coma is, by this method of reckoning, less valuable than 1 year of health and then death.
It isn't obviously absurd, this method of measurement: but then they go on to make the next step. They assign a value to each QUALY. Currently it's around £35,000 (around $60,000) a year. If the treatment costs more than that $60,000 then you don't get it. If less, then the NHS can offer it. Don't forget, it's not one year of extra life, it's one extra year of "good quality" life, as measured by the bureaucrats, that they will spend $60,000 on.
So what is the effect of these calculations? Well, Herceptin was banned until just a couple of months ago. In fact, if you had paid all your life into the NHS (it's funded by a payroll tax, just like Medicaid and Medicare) and your breast cancer was not responding to treatment, well, you just couldn't have Herceptin. No, sorry, go home and die was the message.
Unless, of course, you decided that you would pay for Herceptin privately: then you could of course have it. But, and here's the shocker: if you bought it privately then all of your other treatment would also have to be private. Yes, all of that other treatment which you had been paying for all your working life would be withdrawn. That's some recission, isn't it?
Not so much deadly doctors as deadly bureaucrats then.
But Herceptin is very expensive, no one really knows if it works all that well yet, maybe this is just an oddity? No, any and every treatment that costs more than $60,000 per QUALY is similarly banned. To see what is meant by this see the story of drugs for Alzheimer's. You can see pieces of the story here, here and here. Aricept and two other drugs, Reminyl and Exelon, are, or at least can be, used in the treatment of Alzheimer's. NICE decided that they should not be used in people in the advanced stages of the disease, nor in those in the early stages. Only for those in the middle, for those losing their minds.
No, this decision was not taken because the drugs don't work: it was taken because the drugs are too expensive for the help they do give. The drugs cost $4 a day per patient. Yes, that's right, the rationing in this national health care system means that people who are quite literally losing their minds are denied drugs that cost $4 a day.
You might want to call that deadly doctors, you might want to call it something else a little stronger. But what it really should be is a warning about what national health care can end up being like. The bureaucrats get to decide what treatment you do or do not get, not your doctor.
Comments
Dear Tim Worst(of)all
Just look at Germany, not UK ... Our universal health insurance & care system doesn't leave any one out, is cheaper and offers more than any normal American health insurance system ...
And we are TOTALLY free in the choice of our doctors and hospitals in whole Germany and partially in the whole rest of Europe :-)
The French system is also lots better than US.
But Americans mostly know nothing about the rest of the world, as demonstrated by the fact that only 21,7 percent of all Americans posses a passport :-) In Germany 98% do, and 93% visited at least one foreign country.
We know how it looks elsewhere. You, Americans do not, you leave in deepest provincialism.
Obama is right, but the "tcot mob" can't accept it. Republican vandals and proto-fascists try to take revenge for their total defeat 2008.
But, no chance, dear colleague
Regards,
Prof. Dr. Mihai-Robert Schwartz
I do know something of the rest of the world, in fact I have spent almost a year in your beautiful country.
"Americans know nothing about the rest of the world" how very elitist of you=) please remember the last two times you took this attitude and where that got you before using blanket statements like this.
I do agree we need some sort of cost control in our health care system but you are inferring just because your system is cheaper its better. High tech medical care in the U.S. is far superior then in Germany, if you get cancer or have heart disease you want to be in my country.
I spent sometime in one of your hospitals in Stuttgart the care givers were friendly but the equipment was not the standard I was use to seeing.
Not to sound "elitist" but I don't see folks flocking in droves to your country for elective surgeries.
Show up to an ER in this country and you get treated! Just ask California's illegal immigrates.
Best wishes,
Uninformed American
I live in the UK and i disagree with this author. Yes our NHS is not perfect but no one gets left behind, if any one needs a doctor they have access to one, if one needs to be admitted to hospital they will at no charge.
What seems interesting with this Health Care Reform most of the people making the noise are themselves without Health Insurance.
This is not a democtrat nor a republican issue it is just common sense, everyone will be covered with no pre-conditions or a look at you medical history.
Another interesting point is that given the hard times the whole world is going through with many people losing their jobs hence their health insurance this plan would be viewed as a good plan.
The US govt runs healthcare for the military and many republicans agree it does a good job but when it comes to covering everyone else then the republicans turn around and say it won't do a good job.
I think it's all just a matter over ideology over reason i.e. people refusing to see sense.
Every hour of every day in this country health insurance companies decide which medical treatments they are or are not willing to pay for. The idea that we do not have de facto "rationing" is absurd. Certainly any American who loses coverage because of a pre-existing condition, or who simply loses coverage because they have lost their job suffers "rationing" far beyond the imagining of anyone in the U.K.
The best way to avoid rationed health care is to enact a system that controls the crippling growth in medical expenses. The current proposals, including a that for a Medicare cost commission that would function like the very succeassful military base closing commission, represent the best chance for controlling costs. And I have yet to hear any credible alternatives offered by the other side.
I live in the UK, and lived in America for much of my life.
I can tell you from personal experience when I got cancer I was happy that I lived in the UK. From diagnosis to surgery to aftercare, my treatment outshined any care I ever received in the US. I owe my life to the NHS, and now that I've survived two years past my surgery, I've applied for UK citizenship.
I feel for Americans stuck in jobs that hate because of the health insurance, and for those who go bankrupt because of medical expenses. What a crazy system for a supposedly advanced country.
Got something to say?
Examiner.com is looking for writers, photographers, and videographers to join the fastest growing group of local insiders. If you are interested in growing your online rep apply to be an Examiner today!