The New York Times has noticed the crass utilitarianism that permeates the UK’s NHS—run by the Orwellian-named bioethics board National Institute for Health and Clinical Excellence (NICE)—and seems to be softening the ground for our accepting similar utilitarian overlords here. From the story:
When Bruce Hardy’s kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British, and the British health authorities refused to buy the medicine. His wife has been distraught.If an HMO did such a thing, the Times would never stop screaming. But with the prospects of a nationalized health care system growing, attitudes at the Gray Lady are apparently changing, with the term “evidence based” health care as the euphemistic honey to help the bitter medicine go down.
If the Hardys lived in the United States or just about any European country other than Britain, Mr. Hardy would most likely get the drug, although he might have to pay part of the cost. A clinical trial showed that the pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000. But at that price, Mr. Hardy’s life is not worth prolonging, according to a British government agency, the National Institute for Health and Clinical Excellence. The institute, known as NICE, has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen’s life.
Lest you think such policies will never happen here, it is already being advocated by many of our betters among the intelligentsia:
At the present rate of growth, medical costs will increase to 25 percent of the nation’s gross domestic product in 2025 from 16 percent, with half of the increase coming from new drugs and devices, according to the Congressional Budget Office.Make no mistake: This is the opening round of the coming debate about national health care that will, if it succeeds, put utilitarian bioethicists in position of tremendous power over all of our lives. It is up to us to make sure it does not happen.
To arrest this trend, the United States needs to adopt at least some of NICE’s methods, said Dr. Mark McClellan and Dr. Sean Tunis, who served earlier in the Bush administration as, respectively, administrator and chief medical officer of the Center for Medicare and Medicaid Services. Dr. Tunis said he spent a lot of time in government “learning about NICE and trying to adopt the processes and mechanisms they used, and we just couldn’t.”
That’s because the idea of using price to determine which drugs or devices Medicare or Medicaid provides has provoked fierce protests. But Dr. McClellan said the American government would soon have no choice.
