Friday, May 28, 2010

The danger of health care rationing

The following is from the April/May 2010 issue of National Right to Life News. Written by NRLC President Wanda Franz, it explains the pro-life concern with health care rationing and the effect of the new health care overhaul.

By Wanda Franz, Ph.D.

The National Right to Life Committee is committed to protecting the lives of innocent persons from conception to natural death. Thus, our mission ranges from defending the unborn from abortion to protecting older people and those with disabilities from euthanasia. One form of involuntary euthanasia occurs when people are denied health care that they need to save their lives.

Denial of lifesaving care occurs when rationing of health care is imposed in order to cut costs. Such cases of care denial have been reported in many countries with government-run health care programs, especially those in Canada and England. Care is rationed by simply denying the use of expensive newer drugs and denying or delaying therapies -- especially for elderly patients. Data from Canada and England indicate that the survival rates for many illnesses are much lower than in the United States where the drugs and therapies are readily available.

One of the worst fears of the elderly is that they will not be able get the medical care they need because it isn't considered "cost-effective" by someone else. This has never been a widespread problem in the United States. However, is that about to change? Do pro-lifers have to worry not only about the lives of the unborn but also their own? Is our health care system about to change for the worse? The passage of the Obama Health Care Reform unfortunately has made the answers to these questions a definite "yes."

NRLC's Powell Center for Medical Ethics has been warning about this potential threat during the entire debate on the bill. "Over-promising plus under-funding forces rationing," says the Director of the Center, Burke J. Balch, J.D. The history of government-run health care programs in other countries has demonstrated that they are not financially sustainable. Sooner or later such programs run out of money. As funding is limited, rationing is imposed to save money.

We already have evidence for this in the United States. Massachusetts instituted universal health insurance coverage in 2006 with subsidies for the low-income uninsured so they could afford the mandated policies. Already, the state is finding that the expected savings did not materialize. It appears that costs were larger than predicted; and the system ran out of money sooner, rather than later. Under normal circumstances, people would simply begin to pay more, out of their own pockets, to get care that the government program could not provide. Or, alternatively, they would make their own considered decisions about what forms of health care they would like to have.

We are already doing that with Social Security pensions. Most people recognize that they will not be able to live comfortably on Social Security benefits alone, so they seek other pensions or make additional retirement investments for themselves to cover the gap between what Social Security provides and what they actually need or would like to have.

When it comes to health care, "progressives" find the equivalent solution unacceptable. It creates a "two-tiered" system, they protest: a system that would provide government-mandated care to one class of people and better care for those who are well-insured or are willing to spend their own money for it. That arrangement strikes the "progressives" in and out of government as "unfair."

What is the "progressive" solution? Prevent those who would want to buy better care from doing so. In Massachusetts, the current governor has introduced a bill that would limit what anyone can pay for health care. If you limit what people can pay for things, they will only be able to buy a limited product. Thus, if this bill passes, Massachusetts will have a system where everyone will have equally poor care. This is rationing and this is what we are facing in America. President Obama called it "bending the cost curve."

How would the Health Care Reform Bill "bend the cost curve"? It uses the same approach as that of the governor of Massachusetts. The Robert Powell Center for Medical Ethics reports that "Section 3209 of the health care bill ... effectively allows federal bureaucrats at the Centers for Medicaid and Medicare Services of the federal Department of Health and Human Services to bar senior citizens from adding their own money, if they choose, to the government contribution in order to get private-fee-for-service Medicare Advantage plans less likely to ration lifesaving treatment."

The Medicare Advantage plans were part of a legislative package passed in 2003 with the encouragement of the National Right to Life Committee. In a complex, indirect way, Section 3209 of the Health Care Reform Bill will change the old law to make it possible for the federal government to follow the Massachusetts example at any time it wants. It took the bureaucrats of Massachusetts only a few years to seek to impose rationing. How long will it take the federal government?

There is a second way that the Health Care Reform Bill rations health care. It creates an 18-member "Independent Payment Advisory Board" that will provide suggestions every two years for limiting what everyone spends on health care. Government bureaucrats will then have the authority, based on its recommendations, to set "quality and efficiency" standards that doctors will be forced to follow. Your health care will ultimately be determined by the government, not by doctors, when this section of the bill goes into effect after 2015.

When you go to your doctor, he normally will give you a list of possible treatments. Then, however, he will face sanctions if he offers those that are not allowed by the government-imposed "quality and efficiency" standards. Even if he believes that an "unapproved" treatment would be the best for your particular case, his hands will be tied. He will not be free to make only the medically appropriate treatment decisions. Instead, every medical decision will also be a political decision.

This is today's reality. The law legitimizing these practices has been passed. This law will lead to involuntary euthanasia in the "Land of the Free" -- supposedly free. We must work to repeal the new Health Care Reform Law not only to prevent government funding of abortions, but also to prevent government-sanctioned denial of health care when our own lives are at stake. Please join us.