Originally Posted At
IBD Editorials
July 31, 2009
At a town hall meeting at AARP headquarters in Washington, D.C., President Obama was asked by a woman from North Carolina if it was true "that everyone that's Medicare age will be visited and told they have to decide how they wish to die."
At first, the president joked that not enough government workers existed to ask the elderly how they wanted to die. The idea, he said, was to encourage the use of living wills and that critics were misrepresenting the intent of the "end of life" counseling provided for in the House bill. He did not say, "No, they wouldn't be contacted."
This administration, pledging to cut medical costs and for which "cost-effectiveness" is a new mantra, knows that a quarter of Medicare spending is made in a patient's final year of life. Certainly the British were aware when they nationalized their medical system.
The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror movie script.
The U.K.'s National Institute for Health and Clinical Excellence (NICE) basically figures out who deserves treatment by using a cost-utility analysis based on the "quality adjusted life year."
One year in perfect health gets you one point. Deductions are taken for blindness, for being in a wheelchair and so on.
The more points you have, the more your life is considered worth saving, and the likelier you are to get care.
People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
The British are praised for spending half as much per capita on medical care. How they do it is another matter. The NICE people say that Britain cannot afford to spend $20,000 to extend a life by six months. So if care will cost $1 more, you get to curl up in a corner and die.
In March, NICE ruled against the use of two drugs, Lapatinib and Sutent, that prolong the life of those with certain forms of breast and stomach cancer.
The British have succeeded in putting a price tag on human life, as we are about to.
Can't happen here, you say? "One troubling provision of the House bill," writes Betsy McCaughey in the New York Post, "compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, Pages 425-430)."
One of the Obama administration's top medical care advisers is Oxford- and Harvard-educated bioethicist Ezekiel Emanuel. Yes, he's the brother of White House Chief of Staff Rahm Emanuel and has the ear of his brother and the president.
"Calls for changing physician training and culture are perennial and usually ignored," he wrote last June in the Journal of the American Medical Association. "However, the progression in end-of-life care mentality from 'do everything' to more palliative care shows that change in physician norms and practices is possible."
Emanuel sees a problem in the Hippocratic Oath doctors take to first do no harm, compelling them "as an imperative to do everything for the patient regardless of cost or effect on others," thereby avoiding the inevitable move toward "socially sustainable, cost-effective care."
During the June 24 ABC infomercial on health care broadcast from the White House, Obama confessed that if "it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care."
Not, apparently, if it's your grandmother.
Exit Not An Option In Chuck Schumer's America. New York Senator Chuck Schumer has introduced the Fugitive Taxpayer Act of 2012 to re-impose taxes on expatriates after they flee the United States and take up residence in a foreign country. Proposal also would impose a mandatory 30 percent tax on the capital gains of anybody who renounces their U.S. citizenship and would bar such individuals from ever reentering the United States again.
