- The Washington Times - Friday, June 19, 2009


If you have any sense that you may be getting sick in the years ahead, I suggest you get sick immediately. If you will need of surgery or any medical procedure, do it now! If not immediately, be certain that you hand yourself over to the health care professionals before Oct. 15. That is the date on which President Obama hopes to sign his health care bill once it has gone through the congressional baloney grinder.

At the heart of Mr. Obama’s plan is his stated goal to cut medical costs. That might sound good to you, but it means cutting services, nurses, technicians, medical tests and, most prominently, the use of expensive technology. The president’s top medical advisers are quite frank about this.

Dr. Ezekiel J. Emanuel, brother of White House Chief of Staff Rahm Emanuel and a health-policy adviser in the Office of Management and Budget, has chided Americans for the expense of their “being enamored with technology.” Dr. David Blumenthal, another key Obama adviser, charges medical innovations as being responsible for fully two-thirds of the annual increase in health care spending. Their solution is to limit expensive innovations. A 2008 Congressional Budget Office report agrees with their cost analysis but concludes happily that such innovations “permit the treatment of previously untreatable conditions.” As I shall show, there are more humane ways to cut health care costs.

Also at the heart of Mr. Obama’s plan is the restriction of services for older people, people 65 and older who, by virtue of modern medicine, may actually be 10 and 15 years younger in terms of good health than they would have been a generation ago. Alas, they still have higher health risks and costs than younger people. Thus, they are going to bear the brunt of the Obama administration’s cost cuts, for 27 percent to 30 percent of Medicaid spending is spent for caring for people at the end of their lives.

With the government taking over more of the nation’s health care costs under the Obama regime, it has already been decided that government monies are more economically spent on younger people than on older people. If a 65-year-old needs a hip replacement, the government will better spend that money on a younger person whose hip will last longer. Or perhaps the government will decide the money is better spent on preventive medicine for younger people.

In the federal stimulus legislation that the president signed Feb. 17, we find funding for a Federal Coordinating Council for Comparative Effectiveness Research. “Comparative effectiveness research” is a term used by economists in health care for making health comparisons based often on age and for limiting care based on a patient’s age. In Great Britain, comparative-effectiveness research is actually used to deny patients treatment for age-related diseases such as heart disease and macular degeneration.

When the federal stimulus bill was going through Congress, there were warnings regarding the consequences of comparative effectiveness research. Rep. Charles Boustany Jr., Louisiana Republican and a heart surgeon, warned it would lead to “denying seniors and the disabled lifesaving care.”

Yet the policy remained in the bill along with requirements for doctors’ offices and hospitals to maintain data banks on patients while creating a national network to monitor patients’ care.

The good side of that is that a central database can send out the latest information on treatments, although doctors who keep up with their medical journals already know about these treatments. The dark side is that it will allow the federal government to control how our doctors treat us. The bill speaks of “appropriate” and “cost-effective” care and provides penalties against doctors beginning in 2014. Now there is an Orwellian twist to the Obama promise of “hope” and “change.”

As Betsy McCaughey has written in a groundbreaking analysis of the Obama health care proposals, draconian cost-control measures are not the answer to health care reform, and they are based on erroneous data. Health care’s spending increases over the past five years have been about half what they were in the recent period before that. Average family spending on food, energy and health care have remained the same for decades. Moreover, contrary to myth, there are not 47 million uninsured Americans but actually about 22 million. Rather than pass a health care reform that will mercilessly limit health care to older citizens - and to chronically ill citizens - while still increasing federal expenditures by at least a trillion dollars, she suggests a modest reform, to wit, debit cards for the uninsured and the needy.

In a recent installment of Spectator.org, Ms. McCaughey wrote, “Providing sliding scale assistance, based on household income, to families to purchase coverage would cost $20 billion to $25 billion a year.” That is one reform that will deal with our present problems. There are others, which I shall take up in later columns. What we do not need is George Orwell’s Big Brother overseeing the rationing of health care to senior citizens, particularly senior citizens with years of life ahead of them.

R. Emmett Tyrrell Jr. is the founder and editor-in-chief of the American Spectator, a contributing editor of the New York Sun, and an adjunct scholar at the Hudson Institute.

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