I wrote here a few weeks ago about how Donald Berwick, the president’s appointee to run Medicare and Medicaid, is a big health care rationing advocate. Now, his boss, Kathleen Sebelius, the Secretary of Health and Human Services, has more than implicitly agreed with Berwick’s position. From the story:
Berwick, a professor at Harvard Medical School, has repeatedly indicated his support for rationing and for the single-payer, government-run health care system of Great Britain…Berwick defended the program and rationing health care. “The decision is not whether or not we will ration care–the decision is whether we will ration with our eyes open,” Berwick said in a June 2009 interview with Biotechnology Healthcare.
At a Wednesday press conference on Capitol Hill, CNSNews.com quoted this statement by Berwick to Sebelius and asked her whether she agreed with it. Sebelius responded by saying she believed Berwick is the right man for the job and is “well-suited to help increase the quality of health care.” “I’m really pleased that the President nominated Dr. Donald Berwick,” Sebelius said. “He’s known nationally as an enormously competent physician and an enormously passionate health care provider and someone who, I think, is incredibly well suited to help increase the quality of health care delivered to the 40-plus million Americans who rely on Medicare services and also the 30-plus million on Medicaid services. “He’s written extensively, he’s taught all over the country, and I think he’s absolutely the right leader for this time.”
Don’t you hate that kind of prevaricating by government officials? It is an easy answer, either she agrees with his rationing position or she doesn’t. Sebelius’s non-answer answer, trying to change the question to a matter of Berwick’s competence, spoke volumes. And indeed, when pressed, she more than tacitly admits her support for rationing:
When pressed to answer the question of whether or not she agreed with Berwick’s statement about health-care rationing, Sebelius indicated she already had. “I just gave you the answer,” she said.
And notice that Speaker Pelosi, who was there, jumped in to cut off further discourse. Too late: The cat was out of the proverbial bag.
It seems to me that Sebilius’s clear support of medical rationing, along with the appointment of Berwick, and the influence of people like Tom Daschle, the influence of Ezekiel Emanuel and Cass Sunstein, etc., prove the lie of President Obama’s many assurances that health care reform would not lead to rationing. To keep this post from becoming a book, let’s just focus on a couple of Obama’s own statements.
For example, on June 15, 2009, in a speech to the American Medical Association, Obama said that charges of rationing were a “fear tactic.” From the speech:
We know the moment is right for health care reform. We know this is an historic opportunity we’ve never seen before and may not see again. But we also know that there are those who will try and scuttle this opportunity no matter what – who will use the same scare tactics and fear-mongering that’s worked in the past. They’ll give dire warnings about socialized medicine and government takeovers; long lines and rationed care; decisions made by bureaucrats and not doctors. We’ve heard it all before – and because these fear tactics have worked, things have kept getting worse.
By employing the term “fear tactic,” the president is clearly denying the charge, because if rationing is part of Obamacare, it isn’t a fear tactic, but rather, a fact tactic.
The president went even further, explicitly denying the rationing charge in a speech dated July 18, 2009. From the speech:
Finally, opponents of health reform warn that this is all some big plot for socialized medicine or government-run health care with long lines and rationed care. That’s not true either. I don’t believe that government can or should run health care. But I also don’t think insurance companies should have free reign to do as they please.
So, either Obama knew Obamacare would lead to rationing and wasn’t telling the truth when he said it wouldn’t, or his Secretary of Health and Human Services is taking it in that direction without his consent, a highly dubious proposition.
The time has come to call health care rationing what it is; invidious discrimination by a polite name. Once the centralized planning of medical delivery is complete–with cost containment boards controlling the standards of care and the extent of coverage for both the private and public sectors–insurance companies, HMOs, and the government will be able to legally discriminate against the sickest, most disabled, and most elderly in our country–in other words, those whose care is most expensive. Making maters even worse, now, when a private company denies efficacious treatment, it can get into big trouble from the lawyers and regulators. But with rationing, the lawyers will be disarmed by government fiat and the regulators will be on the side of the rationers instead of the patients.
Unless the centralized control authority of Obamacare is revoked, the government will, in effect, impose a duty to die through rationing on the most weak and vulnerable–which eventually means on all of us. Repeal. Replace. Reform. Defund.
May 31st, 2010 | 9:51 pm
[...] This post was mentioned on Twitter by Vince Humphreys, Stand In The Gap and Pedro Sykes, Wesley J. Smith. Wesley J. Smith said: Obamacare: Sebelius’s Open Support of Health Care Rationing Gives Lie to Obama Assurances » Secondhand Smoke | http://shar.es/mJdIj [...]
May 31st, 2010 | 11:39 pm
For Obama and his co-conspirators, it’s ALL about control.
Whether it’s health care, banking, cap and trade, you name it.
And to them, their end justifies their means.
Lying and deception does not bother them in the least.
The whole lot of them are the worst that this country has ever seen!
June 1st, 2010 | 12:40 am
[...] Read the original: Obamacare: Sebelius's Open Support of Health Care Rationing Gives … [...]
June 1st, 2010 | 1:17 am
[...] Read more here: Obamacare: Sebelius's Open Support of Health Care Rationing Gives … [...]
June 1st, 2010 | 1:48 am
[...] here to read the rest: Obamacare: Sebelius's Open Support of Health Care Rationing Gives … By admin | category: care health private | tags: board-controlling, centralized, extent, [...]
June 1st, 2010 | 3:54 am
[...] the original post: Obamacare: Sebelius's Open Support of Health Care Rationing Gives … Categories: Health, Object Tags: donald-berwick, few-weeks, Health, his-boss, kathleen-sebelius, [...]
June 1st, 2010 | 5:11 am
[...] Read full story [...]
June 1st, 2010 | 5:15 am
Great post. I am linking to it on my on web page, ObamaCareDelendaEst.com, which is a daily clearinghouse for anti-ObamaCare stories. Keep up the good work.
June 1st, 2010 | 11:04 am
1. We already have rationing – look at what “health insurance” companies do to some patients.
2. Repeal? That will be as successful as attempts to get intelligent design taught as science in schools. In fact, repeal is already underway and not going so well: http://thehill.com/homenews/house/100369-gop-moves-to-repeal-healthcare-law
3. [Irrelevant and disrespectful anti religion comment deleted. David, stop it or you are gone.]
June 1st, 2010 | 11:55 am
1. We are not “rationing.” Health insurance companies do sometimes deny efficacious care, and we have means in place (our courts, insurance regulators) that would themselves become much less efficacious should we allow this law to remain in place.
2. That actually gave me a chuckle. What happened to “yes we can”? Guess it really mean “ramming through legislation in the most cynical, unethical way possible.” But yes, we can repeal the law–this is still the USA, and we still get to vote, in spite of the crackpots who want to make Obama emporer.
Wesley J. Smith Reply:
June 1st, 2010 at 12:01 pm
Aimee: And there can be no repeal until after the November election in any event, except by a court ruling of unconstitutionality.
June 1st, 2010 | 1:06 pm
Though Obama’s attempt to reduce the irrational fears around rationing by indicating they would not happen was definitely not accurate, the problem is still fundamentally that the fears are irrational and fear mongering is attempting to blow them out of proportion.
Rationing is a fundamental premise of any system based on real dollars; only so much money can be spent to treat people. This is independent of whether private insurers, individuals or a central planning agency is making the decision on what will be paid for.
For those who talk of rationing limiting access to treatment options, they are arguing about a ‘freedom’ that exists for only those people who can afford $200 thousand in treatment without facing severe financial hardship. In contrast, rationing by a central medically trained organization attempts to limit procedures that cost a lot but have little value such as drugs that add a few more months of life, but at considerable cost.
As well, such assessment organizations take indirect input from politicians rather than being directly under their control so the whole concept of power over others factoring in to the approach is another effort at disseminating fear.
In countries with this rationing, the available treatment are constantly reevaluated as cost and effectiveness change. At the same time, because it is government controlled, individuals can lobby to change what is covered. This is in stark contrast to rationing imposed by the insurers to which the consumer has little, if any, recourse.
June 1st, 2010 | 1:53 pm
Aimee:
Evidence and data supporting/confirming my contention:
“We believe there’s a better way to control costs by controlling utilization and getting people involved in their health care.”
-Cheryl Tidwell, Humana
“In America, we strictly ration health care. We’ve done it for years. But in contrast to other wealthy countries, we don’t ration medical care on the basis of need or anticipated benefit. In this country, we mainly ration on the ability to pay. And that is especially evident when you examine the plight of the uninsured in the United States.”
-Arthur Kellerman, MD, Associate Dean, Emory U School of Medicine.
“I think there’s a very real sense that we are rationing payments to primary care, and what that leads to is poor care. It leads to five-minute visits that many patients are experiencing”
- Elliott Fisher, MD, Dartmouth College
Yes, I have seen rationing, excuse me, “controll[ed] utilization”. I have seen patients denied coverage due to bizarre “technicalities” labeled as pre-existing conditions that medical staff has to painstakingly explain to some ignorant lawyer that no, they are not, in fact, pre-existing conditions. Meanwhile, the patient suffers due to stress over ‘will I be covered or not, why are they doing this to me, etc’
Economic aspects of rationing, exist, too. Economic textbooks essentially define rationing as the distribution or allocation of a limited commodity.
“Already, we [in the US] cannot afford every form of medical care that we might like. So we ration.”
-David Leonhardt
Additionally, many arguments over cost in health care are misguided. It won’t go down, relatively (comparatively it can). “Baumol’s Effect” in economic theory suggests so; reality supports this.
Just because you wish rationing doesn’t exist, doesn’t make that reality. Re-labeling just sets up a false syllogism. This anemic “argument” fails, as will attempts to repeal.
I do have concerns that Obamacare will lead to some types of new rationing, yet eliminate many others.
It’s the Death Panels that scare the bejebis out of me.
Finally, it would probably be easier to get court ruling. With John “Elephant Whistle*” Roberts at the ship of fools’ helm, you will have no better chance to crash that boat.
*if you want to see an idiot in action, check that logic out, whew
My 3rd comment was neither disrespectful nor irrelevant on three counts: 1) people exist who feel that human health is in control of an unseen diety and therefore Obamacare is unnecessary and should be eliminated 2) people exist who feel praying to a diety will directly heal them and this diety controls health outcomes 3) there is significant overlap between certain religious mythologists and those who want to eliminate the health care reform act, ie, First Things is a religious-mythology site: “First Things is published by The Institute on Religion and Public Life, an interreligious, nonpartisan research and education institute whose purpose is to advance a religiously informed public philosophy for the ordering of society.” (wow!)
Smith, do you really want to boot me??
Look at how many commentors respond to me. Comments, probably, = ratings. I wouldn’t be surprised if a few folks peek in to see what I type, too. This blog sure seems to care a lot about my quips.
Think about it.
Wesley J. Smith Reply:
June 1st, 2010 at 4:07 pm
I don’t want to boot you, not because you stimulate debate but because I believe strongly in free expression. I have only booted one person (twice) because he/she became threatening. But I want you to be respectful to people who hold religious beliefs here. You can snark me all you want, but not that–which will only generate responses. I don’t want this blog to be a site that debates religion And it was quite irrelevant to the points of the post, that A) health care rationing is in the cards, and B), that Obama and the law’s supporters misled us when they claimed it wasn’t.
June 1st, 2010 | 5:18 pm
Re: Daniel’s post:
“Irrelevant religious comment deleted” ??? Really, Wesley: why not let us grownups decide whether comments are irrelevant instead of appointing yourself censor.
I understand, given the religious affiliation of First Things that intolerance for, and censorship of, other people’s opinions is an old friend of your web hosts’. While the Index Librorum Prohibitorum is officially dead, a list of just a few writers’ names and dates of appearance on it are worth recalling: Descartes (1663), Hobbes (1703), Voltaire (1804), Hume (1827), Zola (1898), Maeterlinck (1914), Anatole France (1922), Sartre (1948), Moravia (1952), Gide (1922) …. but why belabor the point. The company you keep seems to point unquestionably to where your concerns about “ethics” and the “unique characteristics of humans” truly lie — no matter how much you protest that you “don’t so religion.”
Is it fear that your host might become upset, that impels you to take up your blue pencil? Or are you just carrying on the tradition of Opus Dei?
Wesley J. Smith Reply:
June 1st, 2010 at 7:14 pm
This is my blog and I moderate the comments. I insist on a certain decorum because my name and reputation are attached to this blog. I don’t even know who you or most other commenters here are. Hence, I will allow what I want on the comments section, which is mostly everything. But I am not going to permit irrelevant put downs of religion, I will not allow racist epithets, sexist epithets, etc. . I have even protected you from unwarranted name calling.
June 1st, 2010 | 7:27 pm
“While the Index Librorum Prohibitorum is officially dead, a list of just a few writers’ names and dates of appearance on it are worth recalling: Descartes (1663), Hobbes (1703), Voltaire (1804), Hume (1827), Zola (1898), Maeterlinck (1914), Anatole France (1922), Sartre (1948), Moravia (1952), Gide (1922) …. ”
Er, HW…are you comparing yourself to Descartes, Hobbes, Voltaire, Hume, Zola, Maeterlinck, Anatole France, Sartre, Moravia, and/or Gide?
June 2nd, 2010 | 6:53 am
What a dumb premise. Of course there will be rationing! EVERYTHING is rationed. There will be a budget set aside for the purposes of health care and it will be spent according to some guidelines. And yes, there will be procedures that will not be covered by the program. If you are not satisfied with what you are receiving you can always purchase additional services outside the governmental plan. There is not a single economic activity that is not subject to restraints.
Wesley J. Smith Reply:
June 2nd, 2010 at 10:29 am
Joe Smoke: If that is true, Obama lied. That was the point.
June 2nd, 2010 | 7:56 am
safepres: Hey, congratulations! I’m surprised you even knew who those people were.
I suggest you go back and re-read the thread — and try (really try) to understand what was being said. Try reading it one word at a time, and even breaking down the harder, two-syllable words into one syllable sounds, so you won’t be too badly challenged by the effort. You will then see that the Index comment referred to the organization that runs this website. Not to yours truly. And that the censorship Wesley exercises referred to Daniel’s post. Understand yet? If not, just keep trying; you’ll get there eventually.
June 2nd, 2010 | 8:15 am
Wesley: OK, it’s your blog. I understand that you won’t tolerate outright bigotry, obscene name-calling, and so on. I wouldn’t either. I can even understand your reluctance to permit “irrelevant put downs of religion,” although in my opinion when you censor what you regard as “irrelevant” you prevent readers from determining it for themselves. It also begs the question: does that mean you’ll permit “relevant” put downs, or is any reference to religion off-limits altogether?
Incidentally, for someone who “doesn’t do religion” you certainly have odd tastes in website hosts. :-)
Wesley J. Smith Reply:
June 2nd, 2010 at 10:28 am
History Writer: I have permitted references to religion, I just don’t want the discussions to be about religion, and I don’t want it to get disrespectful. You have accused me, for example, of promoting religion here in the guise of ethics. I permitted it. It wasn’t denigrating. Hypothetical example: If a commenter said assisted suicide is wrong because only God can take a life, I would permit it. If you replied, “I don’t believe in God, so that matters not to me,” I would permit it. If, on the other hand, you wrote, “God is a mythical crutch that only weak people cling to, so get modern,” I would not permit it. If the response to you was that “Atheists are in the thrall of the devil and have no morals,” I would not permit it. I allow people to be sarcastic with each other, but I try to prevent venomous denigration–except when aimed at me.
June 2nd, 2010 | 10:04 am
Wes: “Unless the centralized control authority of Obamacare is revoked, the government will, in effect, impose a duty to die”
Nope, no fear tactics here.
Wesley J. Smith Reply:
June 2nd, 2010 at 10:18 am
padraig: Rationing denies efficacious treatment based on money issues. Example: In Ontario, terminal colon cancer patients are denied coverage for chemo that would extend their lives 6-9 months. In other words, these patients will be forced to die earlier than they would have with the treatment. What would you call it? If a private insurance company did that, the screaming wouldn’t stop and the regulators would be all over them. But once Obamacare’s cost/benefit boards promulgate that kind of restriction–and it will, that’s the point–the same thing will happen here without recourse. Again, what would you call it?
June 2nd, 2010 | 1:14 pm
Whew, sarcasm is on the table. Ridicule, sarcasm, and irony are choice tools.
Actually, I support EFFORTS to repeal the health care legislation.
If this keeps folks mesmerized with chasing the pipe dream and away from the other bird-turd ideas splattered around (ie, drill n’ spill, abstinence only education, advancing corporate welfare, Texas style educashun, unitin’ God n’ guvment, environmental deregulation, elimination of Dept of Education, pointless mercenary supported wars, no campaign finance reform, useless fence building, war on drugs, etc), I’m all for it.
Point being, efforts of repeal may not be useless.
June 2nd, 2010 | 2:03 pm
Back online in the last day and half here at the house, just in time to slam head first into this, my most not favoritest of topics..
I *SO* appreciate you providing those snippets.. One of the things I keep heading towards doing in the last 24 hours is finally flush out a Twitter stalker I have who appeared back on July 23, 2009.. Interestingly enough, that turns out to be five days after one of Obama’s refutals you reference above..
My stalker appeared smack in the middle of the “flag this” (flag@whitehouse.gov) controversy at the end of a day when I got on a particularly determined rip about the hidden rationing possibilities.. To this day, the stalker follows me and only me and has never once typed a word = Alrighty then..
Anyway, coming in to *THANK YOU so much* for all you continue to do.. You’re an irreplaceable soul..!
Warmest from Talking Rock.. :)
PS.. Hey, I tried SO hard for the longest time to track something down on your site.. Just tried again and I’m plum not hitting the right keyword combo..
Off the top of your head, can you remember which story of yours was about that one right-to-die group bragging they had helped write some part into the reform bill..? My computer fried right after that so I lost all the associated bookmarks.. THANK YOU again if you know which one I’m writing of.. :)
~
Wesley J. Smith Reply:
June 2nd, 2010 at 2:51 pm
Cindy Sue: Here is the link: http://www.firstthings.com/blogs/secondhandsmoke/2009/09/06/obamacare-assisted-suicide-promoting-congressman-behind-end-of-life-counseling-provision
June 2nd, 2010 | 2:15 pm
HW-none of those philosophers are banned on this website. Maybe you should try breaking your habit of denigrating others.
June 2nd, 2010 | 3:25 pm
Wes: “In other words, these patients will be forced to die earlier than they would have with the treatment. What would you call it? ”
The status quo (pre-Obamacare). Private companies do NOT have to provide unlimited care. There are limits and deductibles, aka rationing. Plus at the moment the private insurers can just flat out refuse to insure you, no particular reason needed.
All health care is rationed. By outlawing discrimination against pre-existing conditions and expanding Medicare/Medicaid Obamacare is increasing the rations, not decreasing them.
Also, your Canadian colon cancer example is from a single-payer system, and thus irrelevant to any discussion of Obamacare. Not to mention that many private insurers in the USA have used the “delay approval until they die” approach.
Wesley J. Smith Reply:
June 2nd, 2010 at 5:16 pm
They DO have to provide efficacious care. Private insurance can’t refuse life-extending chemo that isn’t experimental. That would change I believe under Obamacare, as it has in Canada. HC is not rationed as in formal rules that prevent coverage for certain people or conditions. Some people have a much more difficult time due to lack of insurance. But that isnt’ the same thing as formal rationing based on government determined categories. And it isn’t irrelevant because under O-Care, the Feds will bureaucratically establish the standards of care and coverage for private health insurance as well as public. It will be centralized control in a mixed payment system.
June 2nd, 2010 | 6:32 pm
Wes:”They DO have to provide efficacious care. Private insurance can’t refuse life-extending chemo that isn’t experimental.”
Defined by whom? Insurance companies are infamous for using both those standards to deny care.
Wes: “That would change I believe under Obamacare, as it has in Canada. HC is not rationed as in formal rules that prevent coverage for certain people or conditions. ”
No, the rationing is hidden as Sebelius pointed out, or paid for by unfunded mandates, such as the “ER HMO” laws.
“Some people have a much more difficult time due to lack of insurance. But that isnt’ the same thing as formal rationing based on government determined categories.”
No, you’re right, it’s much worse. And again, any insurance policy with cash limits and deductibles amounts to formal rationing.
Wes: “And it isn’t irrelevant because under O-Care, the Feds will bureaucratically establish the standards of care and coverage for private health insurance as well as public. It will be centralized control in a mixed payment system.”
That may be the case for folks covered only by Medicare/Medicaid, but I see nothing blocking insurers and HMO’s from offering supplemental coverage beyond the minimal care levels established by the government. Minimal care levels, btw, that would still exceed what many people have access to now.
Wesley J. Smith Reply:
June 2nd, 2010 at 6:57 pm
No, as defined by FDA approval, for example. Believe me, if a health insurance company refuses to pay for efficacious and approved care, they will be liable for a suit for punitive damages for willful failure to pay a just claim. Auto insurance companies can be too. (I am speaking of California.) I used to do that for a living, or better stated, helped the senior lawyers who did.
June 2nd, 2010 | 8:21 pm
Wesley-is the kitty in the picture yours?
Wesley J. Smith Reply:
June 2nd, 2010 at 9:24 pm
No. I get most of my images off of Google images. Once in a while I use my own photos, something of an avocation. But my ego always requires that I take credit. Thanks.
June 3rd, 2010 | 9:00 am
Wes: “Believe me, if a health insurance company refuses to pay for efficacious and approved care, they will be liable for a suit for punitive damages for willful failure to pay a just claim.”
And how many of those lawsuits did you win before the plaintiff passed away?
June 3rd, 2010 | 10:10 am
Oh, THANK YOU, Wesley.. I remember that image from first go-round.. :D
There’s one more, though, where the woman you wrote about then came here to your site to refute that she had not said what she said as was highlighted in your own post..
Her claim on her blog had been something very close to, *if not*, that she actually visited the White House *in person* to meet with one of the higher ups involved in writing the bill.. Before her retraction here on your site, she had originally claimed she was at the White House to assist specifically with right-to-die inspiring verbiage as it was being written.. Does that ring a bell..?
Compassion and Choices was the name that kept coming to Mind when I first tried pulling the article back up, but it’s not them, I don’t think.. It was a very similar group, though, that came across rather small in size (*if* memory is serving correctly)..
PS.. This link you offered is *GREAT* because it has the kind of names I can use for any related transparency in government research my Mind is trying to formalize… :D
Thank you *so much*..
Cyber Hugs.. :)
Wesley J. Smith Reply:
June 3rd, 2010 at 10:47 am
Cindy Sue Causey: Compassion and Choices claimed, bragged, during the run up to passage of Obamacare, that their leaders were intimately involved in creating the language about end of life counseling. That didn’t make it into the final law. If you go to its Web site and do a search, I am sure you will find it.
June 3rd, 2010 | 9:43 pm
[...] Majority Leader Steny Hoyer has defended the appointment of socialized medicine and health care rationing fan, Dr. Donald Berwick, to head Medicare/Medicaid. As to Berwick’s advocacy of rationing, Hoyer punted, saying in [...]
June 8th, 2010 | 11:54 am
[...] It is becoming more evident that Obamacare will ration health treatment and Kathleen Sebelius –with breath-taking powers as HHS head under health reform provisions– is misleading the public about it and about her support for rationing. [...]
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