Obamacare will be 1 big 'death panel'

Just as in U.K., government system will lead to early demise of seniors

President Obama has promised huge cuts in medical spending. In fact, he has warned that, if America fails to make such cuts, it will face financial Armageddon.

"Make no mistake: the cost of our health care is a threat to our economy…," Obama told the American Medical Association in Chicago June 15. "It is a ticking time bomb for the federal budget. And it is unsustainable for the United States of America. … If we fail to act, one out of every five dollars we earn will be spent on health care within a decade. And if we fail to act, federal spending on Medicaid and Medicare… will eventually grow larger than what our government spends on anything else today."

To avoid this catastrophe, America must make drastic cuts in health spending, says Obama. The size of his proposed cuts varies from speech to speech, but the figure cited most often by Obama's advisers is 30 percent per year – up to $700 billion annually.

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A 30-percent annual cut is going to take a big bite out of somebody's health care. The only question is whose.

The numbers make clear that most of these cuts will have to come at the expense of those who need health care the most – the elderly, the disabled and the gravely ill.          

"Older, sicker societies pay more on health care than younger, healthier ones," Obama told the AMA.

He is right. According to a 2006 study by the Department of Health and Human Services, five percent of the U.S. population accounts for nearly 50 percent of health care spending in America. Who are those five percent? Most are people over 65 years of age with serious, chronic illnesses.

By contrast, the study notes, half of the U.S. population "spends little or nothing on health care… with annual medical spending below $664 per person." These, of course, are mostly healthy young people – people without serious, chronic illnesses.

Obviously, Obama will not meet his cost-cutting targets by reducing care to healthy young people. They are already spending next to nothing. It is the old, the dying and the chronically ill whose health care he will cut. The numbers make this clear.

At present, the main vehicle of Obamacare is the so-called America's Affordable Health Choices Act, introduced on June 9.

This law will force Americans to enroll in "qualified" health plans – that is, plans approved and controlled by the government. Americans will be invited to "choose" between "public" and "private" insurance plans, but will find little difference between them. "Public" or "private," they will all follow the same rules, dictated by the Department of Health and Human Services – the same agency, incidentally, which issued the report, titled "The High Concentration of U.S. Health Care Expenditures, 2006."

How will Obama cut costs? His June 13 radio speech gave some hints. Obama said his plan would provide "incentives" to doctors to "avoid unnecessary hospital stays, treatments and tests that drive up costs."

And what sort of treatment does Obama consider "unnecessary?" In an ABC News special June 24, he implied medical treatment might be wasted on elderly people with grave illnesses, citing his own grandmother as an example.

Dying of cancer, with less than a year to live, Obama's grandmother broke her hip. "[T]he question was, does she get hip replacement surgery, even though she was fragile enough they were not sure how long she would last?" asked the president.

It turns out that Obama's grandmother did get the hip replacement – though he did not say so on ABC that night. Obama left the story about his grandmother unfinished, but went on to suggest that other people faced with such choices might do well to forget about surgery and settle instead for palliative or comfort care – treatment that helps you feel better while you are dying, but does not prolong your life.

"Maybe you're better off not having the surgery, but taking the painkiller," Obama concluded.

It's already happening in Europe

In Europe, governments already ration health care, just as Obama plans to do here. The older and sicker people are, the less care they get.

In England, for example, bureaucrats determine a patient's eligibility for health care using the QALY system (quality-adjusted life years). They divide the cost of treatment by the number of "quality" years the patient is expected to live. Older, sicker patients are expected to live fewer "quality" years, so why bother treating them at all? On this basis, British elders are routinely denied treatment for cancer, heart disease and other deadly illnesses.

Many die in filthy, overcrowded hospitals or nursing homes, rife with pestilence, including the deadly, antibiotic-resistant "superbugs" Clostridium difficile and MRSA (methicillin-resistant Staphylococcus aureus). Each year in the U.K., nearly three times more people die from hospital infections than from traffic accidents.

In the nation where Florence Nightingale invented modern nursing 150 years ago, cleanliness has become a lost art. British newspapers reported in 2007 that patients in government hospitals were told to "go in their beds" when they had diarrhea.

In March 2009, British health inspectors reported that poor treatment at one hospital may have killed up to 1,200 people in three years. That's 1,200 people at just one hospital.

Denied food, water and medicine, patients at Stafford Hospital in Staffordshire were left screaming in agony, drinking from flowerpots and lying helpless in their own waste. Many waited for operations which were repeatedly postponed.

British officials were quick to label the Stafford horror an "isolated incident." But many health care professionals in England say it is typical. Unfortunately, dissenters have little voice in Britain's National Health Service. The system is notoriously hostile to whistleblowers.

Take Margaret Haywood, for instance, a nurse of 20 years, who went undercover for the BBC, filming abuse and neglect of elderly patients at Royal Sussex Hospital. In April 2009, British health authorities punished Haywood for going to the press, banning her from practicing nursing. If she had complaints, they told her, she should have made them through proper channels.

In England, whitewashing medical scandals is a bipartisan activity. Conservative and liberal politicians alike defend the National Health Service from all critics.

After a harrowing stay at the Royal United Hospital in Bath, Lord Benjamin Mancroft, a Conservative member of the House of Lords, spoke out in Parliament, declaring, "It is a miracle that I am still alive." He described "filthy" wards that were "never cleaned" and nurses who were "grubby… slipshod, lazy… drunken and promiscuous."

Fellow Tories denounced Lord Mancroft for defaming British medicine. But his observations may help explain why Royal United Hospital leads Britain in superbug fatalities, having racked up 306 superbug deaths in four years.

Government health care supposedly works better in France. But in August 2003, when temperatures in France soared to 104 degrees Fahrenheit, nearly 15,000 elderly people dropped dead – that is, 15,000 more than the average or expected death rate for that time of year.

Most died in institutions, such as government-run nursing homes, which lacked air conditioning and other basic amenities.

Time magazine reported that deaths from the heat wave in France were "geometrically higher than anywhere else in sunbaked Europe," thanks to "a chronically underfunded and understaffed elder care system."

Less money, less care

For 20 years, health care reformers from Edward Kennedy to Hillary Clinton have praised the government-run health systems of Europe and Canada. Obama and his team have taken up the same cry.

A June 1 report from Obama's Council of Economic Advisers praised European health care and urged Americans to emulate it.

If health care is so abominable in Europe, why did Obama's economic advisers commend it? Simple. It's cheaper.

Titled "The Economic Case for Health Care Reform," the report noted that six countries – Canada, Germany, Japan, Sweden, Britain and France – spend only 9.6 percent of their Gross Domestic Product on health care, while America spends 15.3 percent. It recommended bringing our health spending down to European levels through "efficiency improvements in the U.S. healthcare system."

This is the dirty secret behind the movement for universal health care. Its true purpose is to cut medical care, not increase it.

Every plan put forth by health care "reformers" in the last 20 years features drastic cuts – not increases – in health spending. During her 2008 presidential run, for example, Hillary Clinton vowed to slash medical spending in America by $120 billion per year. Obama says he will cut even more.

With "the right kind of cost-effectiveness," Obama's chief economic adviser Lawrence H. Summers told MSNBC's "Meet the Press" on April 19, "we could take as much as $700 billion a year out of our health care system."

Current annual health spending in America is about $2.5 trillion, so Obama and his team are talking about a 30-percent cut.

It happens that the Health Care Financing Administration, or HCFA, reports that 27-30 percent of annual Medicare spending goes to end-of-life care for the elderly – specifically, health care during the last year of life.

These figures suggest Obama could meet his target of a 30-percent cut simply by denying treatment to the sickest and feeblest of America's elderly – those with a life expectancy of one year or less.

Obama's special adviser for health policy, Dr. Ezekiel Emanuel, appears to have something like that in mind.

In a Jan. 31 article in the British medical journal Lancet, Emanuel advised steering health dollars toward the young and fit; specifically those between the ages of 15 and 40, while reducing health spending for the elderly.

Weirdly, Emanuel – along with his co-authors Govind Persad and Alan Wertheimer – made a special point of arguing that age-weighted medical rationing does not violate the rules of political correctness. They wrote:

"Unlike allocation by sex or race, allocation by age is not invidious discrimination … Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-year-olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not."

In other words, to put it crudely, deciding to let the elderly die because we think of them in "stereotypical" terms – say, as useless old dodderers –would be "ageism." However, letting them die for a "good" reason – for example, because they have already had their chance at life, and now it's time to give someone else a chance – is perfectly OK.

In Emanuel's view, letting old people die is not the problem. The problem is finding the right words to justify it.

Words are very important to Emanuel – for example, the words of the Hippocratic Oath. He blames the Hippocratic Oath for much of what he considers wrong in American medicine.

Until the 1970s, all doctors swore this oath upon graduating medical school. It is believed to have been written by the Greek physician Hippocrates of Cos, the father of modern medicine, some 2,400 years ago.

The oath forbids doctors to kill, and expressly forbids administering any "deadly drug" or performing an abortion. For that reason, it has fallen out of favor with modern medical schools, which often use edited versions of the oath, or different oaths entirely, written in modern times.

Still, the tradition of Hippocrates dies hard. Doctors still honor him, and many feel guilty when they violate his precepts.

Emanuel would like to steer modern medicine away from the Hippocratic tradition. In a June 18, 2008, article in the Journal of the American Medical Association, he wrote that strict adherence to the Hippocratic Oath caused "overuse" of medical care.

"Medical school education and postgraduate training emphasize thoroughness," he complained. "When evaluating a patient, students, interns, and residents are trained to identify and praised for and graded on enumerating all possible diagnoses and tests that would confirm or exclude them. The thought is that the more thorough the evaluation, the more intelligent the student or house officer."

Particularly galling to Emanuel is "the Hippocratic Oath's admonition to 'use my power to help the sick to the best of my ability and judgment'" which he says "doctors interpret as an imperative to do everything for the patient regardless of cost or effect on others."

Emanuel would like to see less thoroughness and more cost-cutting. Instead of being "thorough" and "meticulous," doctors should be "prudent" in assessing how much time, effort and money each patient is worth, for the greater good of society, he argues.

Evidently, President Obama likes what Dr. Emanuel is preaching. In December 2008, Obama made him special adviser for health policy to the White House Office of Management and Budget.

Given Emanuel's views, it can be expected that age-weighted rationing will figure prominently in Obama's health care "reforms." Should Obamacare become the law of this land, many of those 80 million Americans born between 1946 and 1965 can look forward confidently to a nasty, European-style death.

It is already happening in Oregon

You don't have to go to Europe to see age-weighted rationing at work. Just take a look at Oregon. Its state-run Oregon Health Plan works very much as our president says Obamacare will work.

Barbara Wagner of Springfield, Ore., was diagnosed with lung cancer in 2005. Chemotherapy and radiation put her cancer into remission. But the cancer returned in May 2008.

Wagner's doctor prescribed Tarceva, a pill which slows cancer growth. There was a good chance it might extend her life by a few weeks or even months.

At age 64, Wagner had two sons, three daughters, 15 grandchildren and seven great-grandchildren. Every moment she could spend with her loved ones was precious.

But Oregon's health commissars nixed the plan. Her Tarceva treatment would cost $4,000 per month. Wagner was going to die anyway, so why waste the money?

Wagner received a letter stating that the Oregon Health Plan would not approve any treatment for her "that is meant to prolong life, or change the course of the disease …" However, if Wagner opted for physician-assisted suicide, Oregon would be happy to pick up the tab, said the letter.

Physician-assisted suicide is legal in Oregon and costs only about $50.

"It was horrible," Wagner told reporters. "To say to someone, we'll pay for you to die, but not pay for you to live, it's cruel. Who do they think they are?"

Wagner finally got her Tarceva when the manufacturer Genentech offered to supply it free of charge. She died in October 2008.

A humble, retired schoolbus driver, Wagner touched more people in death than she had in life. Local and national press picked up her story, alerting many Americans to the danger of medical rationing.

One person who remains untouched by her story is Dr. Walter Shaffer, who heads Oregon's Division of Medical Assistance Programs, which runs the Oregon Health Plan. Regarding the Wagner case, Shaffer told the Eugene Register-Guard, "We can't cover everything for everyone. Taxpayer dollars are limited for publicly funded programs. We try to come up with policies that provide the most good for the most people."

Equally unsympathetic is Barack Obama, who views Oregon's medical rationing system as a model for the nation.

On March 23, 2008, asked to comment on Oregon's assisted suicide law, candidate Obama told the Mail Tribune of southern Oregon: "I think that the people of Oregon did a service for the country in recognizing that as the population gets older we've got to think about issues of end-of-life care."

Richard Poe
Source: WorldNetDaily
Publish Date: August 20, 2009
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