The Canadians may put up with bureaucrats telling them what medicine they can and cannot receive–but we in the US are not so passive. Alas, we could become so if Obamacare passes and we let centralized rationing boards to take control of our entire health care system. If we do, in about ten years, we will begin to see stories such as on reported in today’s Globe and Mail that tells the terrifying story of young women, who need a combination of drugs to fight pulmonary disease, being told–Nyet! And now, as a direct consequence, one woman is close to death. From the story:
Bonnie Cameron and Cindy Waters-Goodman do not know each other, but they have much in common. Both are feisty, small-town Ontarians who were young, busy mothers when hit with diagnoses of pulmonary arterial hypertension, an incurable heart and lung disease…Both were started on a regimen of drugs that are costly but slowed the pace of the disease, which is uncommon and often goes undetected. The province paid much of the tab, which the women estimate was about $100,000 a year each. Their lives improved drastically: They could play with their kids, cook meals and shower without fainting.
Then, last spring, out of the blue, both received letters informing them the province would no longer allow more than one medication. To continue receiving support, they’d have to stop taking combos.
After much lobbying, Ms. Waters-Goodman won a reprieve and can stay on her combination of drugs for one more year. Ms. Cameron wasn’t so lucky. Forced to give up her secondary medication, she has suffered greatly, and this week slipped into critical condition after being moved to hospital in Toronto. With an intravenous line in her neck and several failing organs, she seesaws between life and death.
If an HMO tried to do that here, it would not stand. The screaming would justifiably never stop and government regulators would join fight on the side of the patient. But if we permit centralized cost/benefit/best practices panels–the regulators will switch sides and work on behalf of the cost cutters. Indeed, once we allow centralized cost/benefit panels–which would be run by pro-rationing utilitarian bioethicists–to take charge of both private and public medical decisions, we will end up in the Canadian soup:
The decision, made by the province’s Committee to Evaluate Drugs, alarmed patients and frustrated their doctors.”There’s no question that we cannot do as well in Ontario now for our patients as other places in Canada,” said Dr. Sanjay Mehta, a PAH specialist in London. “This is a human issue. If someone is in front of you doing badly on the first drug, do you just sit and watch until they die?”
Apparently so. That’s what happens when health care is rationed.
We are constantly told health care is a “right.” But under Obamacare, it will be a revocable right to those most in need of its exercise. We have been warned. Death panels anyone?
October 31st, 2009 | 11:59 am
[...] have been warned. More details over at Secondhand Smoke. Comments [...]
October 31st, 2009 | 3:21 pm
[...] crapper and cannot receive–but we in the US are not so passive. View example place here: Obamacare: river Death Panels Prove Lethal Danger of Cost … Posted in Medicine, Uncategorized | Tags: are-not, let-centralized, may-put, Medicine, [...]
October 31st, 2009 | 4:45 pm
Compelling article. The reason that government is incapable of free market-efficiencies, reduces rather than expands choices, and is invariably more concerned about the cost to itself than the benefit to you: you can’t fire the government.
October 31st, 2009 | 5:54 pm
[...] Things Blog Oct 31st, 2009 | 11:59 am. hit been warned Read more from the example source: Obamacare: river Death Panels Prove Lethal Danger of Cost … Posted in Uncategorized | Tags: death, death-panel, details-over, first-things, [...]
October 31st, 2009 | 7:19 pm
But Wesley…imagine you are in the United States and make too much to qualify for Medicaid but cannot afford your own insurance and had this disease. Currently, you would be in even A WORSE situation because you wouldn’t even have had the drug combo paid for at all…and certainly wouldn’t be getting the one paid for now.
HMOs can afford to be pushed to pay for these kinds of drugs because they make profits by (1) refusing to cover those with preexisting conditions and by (2) refusing to pay for certain procedures altogether and by (3) refusing to reimburse for anywhere close to the whole bill for certain procedures. A system that does not do such things is in no position to be pushed because they simply don’t have the money.
The folks who think we can refuse to ration care simply don’t understand the finite human condition: we have virtually unlimited health care needs (we all will die someday) but have very limited health care resources. A refusal to deal with this truth is the ostrich approach which has led to the disaster of a system we have in place today.
November 2nd, 2009 | 9:23 am
Charlie: You make a good point. I would go a step further and suggest that the opposition to health care reform is chiefly political, and that moral arguments against it are a charade; a cynical pretense. It is, after all, hard to imagine any valid moral argument against improving the way in which our country treats some of its most vulnerable citizens.
November 2nd, 2009 | 10:31 am
“Because “there’s a lack of published evidence around the use of combination therapy,” she explained, “… we have not been funding” it.”
again we see how evidence-based medicine impacts our health care system.
I’m from Ontario and as one of the commenters in the original Globe & Mail article stated, Ontario has lost MILLIONS in the eHealth fiasco and continues to insist it will fund full day kindergarten, but we don’t have money for drugs to treat people.
It’s about more than just rationing health care dollars – it’s also about funding the liberal social agenda too.
November 2nd, 2009 | 11:30 am
HW,
Your argument is disingenuous by creating a false choice; either we give power to the government to treat individuals more equally, or we leave power in the hands of the private sector who will continue to short the “most vulnerable.” I think the 20th century has proved in bold, bloody fashion that giving more power to centralized governments to manage society is not necessarily a solution or guarantee for a better outcome.
That you don’t understand or refuse to acknowledge people’s concerns about this and demeaning them as partisan hacks only makes your arguments sound more like stump-speech political slogans than rational arguments: “It is, after all, hard to imagine any valid moral argument against improving the way in which our country treats some of its most vulnerable citizens.”
November 2nd, 2009 | 2:15 pm
I’m not from Ontario (although I am Canadian), so I may wrong in the details, but I don’t think that Ontario has single-payer coverage for medications, as it does for other parts of the medical delivery system. In other words, it’s not like a hip replacement where you either wait in line in the government-funded system, or you go to the U.S. if you are able to pay out of pocket – there are other legal insurance options for medications in Ontario. The government is but one option.
So how is this different than the hypothetical situation in the article of an HMO making an unpopular (and medically suspect) decision? And it looks like that the “screaming” in Ontario has started that could lead to change. Is there really evidence that Canadians would let something like this “stand” whereas Americans would not? And is it really easier to effect change by “screaming” at government to regulate private entities than “screaming” at government to make the change directly?
I don’t think this is an example of health care rationing, at least in the way the author is intending to use it (ie. the government is the sole entity rationing access).
Again, I could be mistaken in the details, but mischaracterizations of the Canadian system (innocent or deliberate) like this really undermines credibility on the subject.
December 4th, 2009 | 4:50 pm
HistoryWriter:
Going from one kind of preventable death to another is some improvement!
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