Good point - in that Obama interview he laid out that there was going to be rationing to save costs. And that it would be by "doctors, scientists, ethicists" in "some independent group that can give you guidance". Thats your "death panel". Of course, there would never be anything CALLED a "death panel", it would have some inocuous or even nice-sounding name - in England its actually N.I.C.E.
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Take the United Kingdom, which is often praised for spending as little as half as much per capita on health care as the U.S. Credit for this cost containment goes in large part to the National Institute for Health and Clinical Excellence, or NICE. Americans should understand how NICE works because under ObamaCare it will eventually be coming to a hospital near you.
The British officials who established NICE in the late 1990s pitched it as a body that would ensure that the government-run National Health System used "best practices" in medicine. As the Guardian reported in 1998: "Health ministers are setting up [NICE], designed to ensure that every treatment, operation, or medicine used is the proven best. It will root out under-performing doctors and useless treatments, spreading best practices everywhere."
What NICE has become in practice is a rationing board. As health costs have exploded in Britain as in most developed countries, NICE has become the heavy that reduces spending by limiting the treatments that 61 million citizens are allowed to receive through the NHS.
online.wsj.com
Okay, that tells us we need to watch out for the "best practices" and "clinical excellence" phrases.
NICE stands firm, but the public must learn to respect rationing
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In May the British Medical Association took the historic step of admitting for the first time that many health treatments will have to be rationed in future because the NHS cannot cope with spiralling patient demand. In A Rational Way Forward for the NHS in England, it argued that some procedures are already in jeopardy.
These include fertility treatment, plastic surgery and operations for varicose veins and minor childhood ailments.
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'Twenty years ago politicians were not honest with people about it. They pretended it was possible for everything to be done. It wasn't then and it isn't now.'
Sir Michael said he hoped this awareness would start to filter through to the media and the public. The NHS does not, he pointed out, have a 'bottomless pit of cash'.
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There is a long way to go to win over the public on the issue of rationing, says GP and Commons health select committee member Dr Howard Stoate. He tells of a woman at his constituency surgery demanding the NHS repaid her after going to Germany to have a hip operation that she would have had to wait three months for on the NHS.
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Health and happiness: quality-adjusted life years
There is a finite amount of money available and each treatment has to be judged on price. NICE uses a system known as the quality adjusted life-year (QALY), which gives each treatment a score for the benefit it gives in the quality and length of life, which is then compared with cost. QALY judges a year of perfect health as 1, while death represents 0. To judge quality of life, factors like mobility, pain, depression, and the ability for self-care are taken into account.
So a treatment that results in four years of life with a health state of 0.75 gets three QALYs, where as four years with health state of 0.5 is two QALYs.
The QALY is combined with cost to give cost utility ratios which are then used to judge treatment.
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NICE technology appraisals are prepared by an independent appraisal committee which includes health professionals working in the NHS and people who are familiar with the issues affecting patients and carers.
hsj.co.uk
That independent appraisal committee sounds like "independent group that can give you guidance" Obama was talking about in that interview and is what Sarah Palin labeled the "death panel".
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"Most time, a man will tell you his bad intentions if you listen, let yourself hear."
Charley Waite, Open Range |
