This summer there was a lot of concern about the use of the term “death panels” — was it a fair description of where we are headed as we move down the very slippery slope of government control of health care or is it just totally over-the-top?
This editorial in the Wall Street Journal describes how a rationing commission currently works in Washington state–and, it may not be a death panel, but it doesn’t sound very pretty:
The Washington commission, called the Health Technology Assessment, is manned by 11 bureaucrats, including a chiropractor and a “naturopath” who focuses on alternative, er, remedies like herbs and massage therapy. They consider the clinical effectiveness but above all the cost of medical procedures and technologies. If they decide something isn’t worth the money, then Olympia won’t cover it for some 750,000 Medicaid patients, public employees and prisoners.
So far, the commission has banned knee arthroscopy for osteoarthritis, discography for chronic back pain, and implantable infusion pumps for pain not related to cancer. This year, it is targeting such frivolous luxuries as knee replacements, spinal cord stimulation, a specialized autism therapy and MRIs of the abdomen, pelvis or breasts for cancer. It will also rule on routine ultrasounds for pregnancy, which have a “high” efficacy but also a “high” cost.
Currently, the commission is pushing through the most restrictive payment policy in the nation for drug-eluting cardiac stents-simply because bare metal stents are cheaper, even as they result in worse outcomes. If a patient is wheeled into the operating room with chest pains in an emergency, doctors will first have to determine if he’s covered by a state plan, then the diameter of his blood vessels and his diabetic condition to decide on the appropriate stent. If they don’t, Washington will not reimburse them for “inappropriate care.”
Democrats have often recoiled at the idea of government attempts to oppose their morality on the public, with saying like “keep government out of our bedrooms.” Fair enough. But shouldn’t want government out of our doctor’s offices too? Should it really be government’s role to decide what’s off limits in terms of care? And once government gets in the business of dictating care, it will feel free to try to steer us toward healthy living… that may mean eating less and exercising more, but where, exactly, does this stop?