What Everyone needs to know about Obamacare

 Will Obamacare Destroy Medicare?

By Scott Geller MD  October 22, 2009

 

 

Who are the people in the United States who really need and use medical care? Ask any Medical Doctor in South Florida..........or for that matter, anywhere in the country.........most patients needing intensive medical supervision and hospital care are Medicare patients.

 

People forget why we created Medicare - people 65 and older (plus the disabled), are usually retired. And since most American don't save for old age, seniors don't have the cash flow to either pay hospitals themselves or buy insurance. Simple to understand.

 

So the most serious question we should be asking about 'Obamacare' is what will happen to Medicare patients .?

 

All one has to do is to get past all the doubletalk, disinformation, and misinformation coming out of the Obama administration, their supporters in Congress, and even the AARP. Laws are not actually written by Congressmen. They are compiled by academic/ideological intellectuals, congressional staffers, and political policy wonks.

 

Forget what the President, Congressmen, or TV newsreaders tell you. We just have to look at the writings and statements of the individuals behind Obamacare to understand their actual intentions.

 

Here's what is really happening now. As part of Obama's 'stimulus package', a Billion Dollars has been earmarked for a new bureaucracy, the 'Federal Coordinating Council for Comparative Effectiveness Research.' The Council is the brain child of former Health and Human Services Secretary Nominee Tom Daschle. These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” Daschle's stated purpose (and therefore President Obama's purpose) for creating the Council is to empower an unelected bureaucracy to make the hard decisions about health care rationing that elected politicians are politically unable to make. The end result is to slow costly medical advancement and consumption. Daschle argues that Americans ought to be more like Europeans who passively accept "hopeless diagnoses." According to Daschle, Seniors should be more accepting of the conditions that come with age instead of treating them.

 

The Federal Council infrastructure is modeled after Britain’s NICE (National Institute for Clinical Excellence), which determines the dollar value of a Quality Adjusted Life Year (QALY). NICE allows payment for treatments that cost less than that, and disallows treatments that cost more.

 

Obama’s regulatory czar Cass Sunstein, who will play a major role in defining government’s role in controlling medical care, prefers the QALY formula

 

This system “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.”

This rationing of medical care by age, so as to deny it to the old, is not  simply an academic idea.  It is implicit in the reports of Peter Orszag. When he was Director of the Congressional Budget Office in 2007-2008 Orszag wrote repeatedly that medicines and treatments should be rationed according to their effect in increasing the number of "Quality Adjusted Life Years" (QALY) of the patient. Placing a dollar-value on human life, Orszag wrote that experts agreed that a QALY was worth $50,000 to $100,000.

 

How does ‘Czar’ Sunstein approach end of life care? In 2003 he wrote a paper for the AEI-Brookings Joint Center for Regulatory Studies arguing that human life varies in value. Specifically, he also champions statistical methods that give preference to what the government rates as "quality-adjusted life years. ( QALY )" Meaning, the government decides whether a person's life is worth living. If the government decides the life is not worth living, it is the individual's duty to die to free up welfare payments for the young and productive.

 

Who else is on the Council? One of its most prominent members is none other than Dr. Death himself, Ezekiel Emanuel, brother of Rham Emanuel, President Obama’s Chief of Staff.  Dr. Emanuel's views on care of the elderly should frighten anyone who is or ever plans on being old. He explains the logic behind his discriminatory views on elderly care as follows:

Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. ( Lancet, Jan.31 )

 

On average 25-year-olds require very few medical services. If they are to get the lion's share of the treatment, then those 65 and over can expect very little care. Dr. Emanuel's views on saving money on medical care are simple: don't provide any medical care. The loosely worded provisions in H.R 1 give him and his Council increasing power to push such recommendations. 

 

Dr. David Blumenthal, another key Obama adviser, agrees. He recommends slowing medical innovation to control health spending.

Blumenthal has long advocated government health-spending controls, though he concedes they're "associated with longer waits" and "reduced availability of new and expensive treatments and devices" (New England Journal of Medicine, March 8, 2001). But he calls it "debatable" whether the timely care Americans get is worth the cost. (Ask a cancer patient, and you'll get a different answer. Delay lowers your chances of survival.)

Obama appointed Blumenthal as national coordinator of health-information technology, a job that involves making sure doctors obey electronically delivered guidelines about what care the government deems appropriate and cost effective.

In the April 9 New England Journal of Medicine, Blumenthal predicted that many doctors would resist "embedded clinical decision support" -- a euphemism for computers telling doctors what to do.

Americans need to know what the President's health advisers have in mind for them. Emanuel sees even basic amenities as luxuries and says Americans expect too much: "Hospital rooms in the United States offer more privacy. Physicians' offices are typically more conveniently located and have parking nearby and more attractive waiting rooms" (JAMA, June 18, 2008).

No one has leveled with the public about these dangerous views. Nor have most people heard about the arm-twisting, Chicago-style tactics being used to force support. In a Nov. 16, 2008, Health Care Watch column, Emanuel explained how business should be done: "Every favor to a constituency should be linked to support for the health-care reform agenda. If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration's health-reform effort."

 

Emanuel bluntly admits that the cuts will not be pain-free. "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely 'lipstick' cost control, more for show and public relations than for true change," he wrote last year (Health Affairs Feb. 27, 2008).

Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).

Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

Emanuel, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).

Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.

 

The minority Party tried to attach an amendment to the law to insure that nothing the Council provides will be used in any health care rationing scheme. It was defeated by the Democratic majority. Can there be any clearer indication of their intentions?

It’s easy for President Obama to trapse around the country promising that his health care scheme won’t “Pull the plug on Granny”. He certainly won’t be doing it. The bureaucracy he set up will do it for him.