Health Care Reform

Justin Taylor offered some thoughts on the health care reform bill today on his blog. He summed up his thoughts in a sentence, “Glad to see that the Senate Finance Committee has agreed not to include end-of-life counseling provisions from the Senate’s version of the health-care reform bill.” He then goes on to quote from Wesley Smith and from an interview with President Obama.

Wesley Smith had explained the provisions as follows:

“We don’t yet know what the final health-care reform bill will look like. But it appears certain that President Obama and his congressional allies hope to establish a centralized board or boards that would be charged with limiting costs by deciding which procedures and drugs would be covered, under what circumstances. The legitimate fear is that such boards, regardless of their benefits, would impose rationing based on invidious categories — such as age, disability, or other “quality of life” measurements. In other words, the boards would deny certain categories of patients treatment available to other categories of patients.

It’s not like the President didn’t warn us. Check out this interview from April 2009 in the NY Times:

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

DAVID LEONHARDT: So how do you — how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

Alright, I’ll admit that I know less about the Health Care Reform Bill than many, but I can still detect faulty logic. Here is where the argument offered by Taylor and Smith breaks down – and I think we need to own this. Taylor and to Smith seem appalled at the idea of a committee being formed to ‘ration’ health care or make decisions based on “age, disability, or other “quality of life” measurements”. I’m with them. It’s disturbing in the extreme. YET, we cannot act as though those kind of decisions aren’t being made know. Ok, it’s not by a committee and not always on the basis of age or quality of life. Instead of a committee market forces (the cost of procedures/medicines, income levels and availability of health insurance, etc) are in the drivers seat. This, to me, is also appalling.

Again, I’m not for the Health Care Bill (based on what I have heard/understood about it). My mind could be changed (I was wrong once back in 2000). But please, let’s not act like decisions about a patients health aren’t being made now by people/forces other than the patient themselves.

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