Posted on 05/13/2009 10:56:07 AM PDT by SJackson
One of the more unproductive elements of President Obama's stimulus bill is the $1.1 billion allotted for "comparative effectiveness research" to assess all new health treatments to determine whether they are cost-effective. It sounds great, but in Britain we have had a similar system since 1999, and it has cost lives and kept the country in a kind of medical time warp.
As a practicing oncologist, I am forced to give patients older, cheaper medicines. The real cost of this penny-pinching is premature death for thousands of patients -- and higher overall health costs than if they had been treated properly: Sick people are expensive.
Click for Editorials & Op-Eds It is easy to see the superficial attraction for the United States. Health-care costs are rising as an aging population consumes ever-greater quantities of new medical technologies, particularly for long-term, chronic conditions, such as cancer.
As the government takes increasing control of the health sector with schemes such as Medicare and SCHIP (State Children's Health-care Insurance Program), it is under pressure to control expenditures. Some American health-policy experts have looked favorably at Britain, which uses its National Institute for Clinical Excellence (NICE) to appraise the cost-benefit of new treatments before they can be used in the public system.
If NICE concludes that a new drug gives insufficient bang for the buck, it will not be available through our public National Health Service, which provides care for the majority of Britons.
There is a good reason NICE has attracted interest from U.S. policymakers: It has proved highly effective at keeping expensive new medicines out of the state formulary. Recent research by Sweden's Karolinska Institute shows that Britain uses far fewer innovative cancer drugs than its European neighbors. Compared to France, Britain only uses a tenth of the drugs marketed in the last two years.
Partly as a result of these restrictions on new medicines, British patients die earlier. In Sweden, 60.3 percent of men and 61.7 percent of women survive a cancer diagnosis. In Britain the figure ranges between 40.2 to 48.1 percent for men and 48 to 54.1 percent for women. We are stuck with Soviet-quality care, in spite of the government massively increasing health spending since 2000 to bring the United Kingdom into line with other European countries.
Having a centralized "comparative effectiveness research" agency would also hand politicians inappropriate levels of control over clinical decisions, a fact which should alarm Americans as government takes ever more responsibility for delivering health care -- already 45 cents in every health-care dollar. In Britain, NICE is nominally independent of government, but politicians frequently intervene when they are faced with negative headlines generated by dissenting terminal patients.
For years, NICE tried to block the approval of the breast cancer drug Herceptin. Outraged patient groups, including many terminally ill women, took to the streets to demonstrate. In 2006, the then-health minister suddenly announced the drug would be available to women with early stages of the disease, even though it had not fully gone through the NICE approval process.
A more recent example was the refusal to allow the use of Sutent for kidney cancer. In January, NICE made a U-turn because of pressure on politicians from patients and doctors. Twenty-six professors of cancer medicine signed a protest letter to a national newspaper -- a unique event. And yet this drug has been available in all Western European countries for nearly two years.
In Britain, the reality is that life-and-death decisions are driven by electoral politics rather than clinical need. Diseases with less vocal lobby groups, such as strokes and mental health, get neglected at the expense of those that can shout louder. This is a principle that could soon be exported to America.
Ironically, rationing medicines doesn't help the government's finances in the long run. We are entering a period of rapid scientific progress that will convert previous killers such as heart disease, stroke and cancer into chronic, controllable conditions. In cancer treatment, my specialty, the next generation of medicines could eliminate the need for time-consuming, expensive and unpleasant chemo and radiotherapy. These treatments mean less would have to be spent later on expensive hospitalization and surgery.
The risks of America's move toward British-style drug evaluation are clear: In Britain it has harmed patients. This is one British import Americans should refuse.
Like the Tax Code, socialized medicine will be used as a weapon too.
America being advanced in terms of medical research, second generation treatments won't be developed, at least in America, if first generation treatments, and their profits, are eliminated.
Social Security and Medicare will go broke unless the retiring baby boomers start dying a lot earlier than they have been. Rationing government health care will take care of that problem. More government power and fewer beneficiaries is a win/win for the collectivists.
But it’s for the children!
Where will the world go for its top-tier medical needs when the US has joined them in second-tier status?
Social Security and Medicare will go broke unless the retiring baby boomers start dying a lot earlier than they have been. Rationing government health care will take care of that problem. More government power and fewer beneficiaries is a win/win for the collectivists.
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SS and Medicare do not need to go broke. Given what Obama is willing to spend on everything for his empowerment, THE TRILLIONS, he can keep it solvent. Marxists want power over EVERYTHING, including your life. See the old movie, “SOYLENT GREEN” that starred Charlton Heston. A great example of “universal healthcare” — or just ask any British citizen.
Despite Daschle, Health Reform To Be a ‘Central Focus’ of Obama Budget (Too old? Too bad.)
Depends on how the program is structured. Britain has a good private hospital system, you simply have to pay for treatment or buy insurance. A private system might be able to coexist. I've heard speculation that large hospital corporations might set up hospitals offshore. It would be on your dime, but treatment would be available, and in depressed areas like the Caribbean, locals and immigrant professionals could do jobs that American's can't do due to government edit. A market will develop for those who can afford treatment, for those can't, look on the bright side, by dying they'll boost the sustainability of social security.
The government will determine who gets to live and who gets to die. The family will have no say in the matter.
Bureaucracies will decide if granny gets her medication or not. "Big Brother" will decide if you need that operation or not. Government knows best, after all. As long as Americans don't care about their rights and responsibilities, the government will continue to take them from us.
It's sickening. Quite literally.
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Oh, that video is him speaking before the Senate !!
When wait-listed at over a year-—Sick Canadians can always come here for treatment and they do by the thousands.
Where will Americans go when the time comes and the wait list is over 10 + months...?
As long as you can afford it, you’ll be able to find treatment overseas. If you can’t afford it, wait ten months.
“The government will determine who gets to live and who gets to die.”
The real 0bama/Democrat plan. Conservatives and Republicans first, followed by all DHSers.
Setting up overseas “hospice” clinics for Americans could well be one of the greatest opportunities “created” by 0bama et al. Think about it. An HMO sets up shop somewhere in the Caribbean and either buys or partners with an exiting hotel. It wouldn’t even have to be a super AAA hotel, it could just be “nice”. I’m talking about a serious, high quality medical facility and rehab hospital. With an affiliated resort, of course! It could become a “faddish” way to take care of elders on track to die. The families could stay at the resorts while the elders are placed in comfortable rehab. Such a resort could attract high quality doctors, and would already be mostly built. It’s a great idea, if I say so myself.
“In cancer treatment, my specialty, the next generation of medicines could eliminate the need for time-consuming, expensive and unpleasant chemo and radiotherapy. These treatments mean less would have to be spent later on expensive hospitalization and surgery.”
Prior to 1940 the number one killer was pneumonia. After penicillin pneumonia became little more than a nuisance. Ditto tuberculosis, polio, gonorrhea, .......
New drugs like Herceptin or Sutent are expensive because of Research and Development costs. As R&D costs are recovered, sales will increase. This will allow the use of much less expensive mass production techniques which will bring still lower costs. These drugs will be come less expensive with time.
The real danger in government employing “comparative effectiveness research” as a means of literally holding the power of life or death over each of their constituents is that our bureaucrats and politicians may actually be too stupid and clueless to understand that they too will be affected.
It will be a tragedy if pharmaceuticals become just another static commodity business with pills being cranked out in static third world economies just as cures for cancer are on the verge of being realized.
The only newspaper to publish an intellegent assement of Obamamessiahfreecare.
That already exists in some places. It’s a great idea, particularly if high deductable, catastrophic were available. Of course non-US health care concerns would have a distinct advantage, since BHO wants American companies paying US income tax on offshore income, but no matter. But not to die, to get treatment. I’d pay for insurance with a $10m or $20m deductable if enabled me to get necessary cancer or heart treatment at Mayo-Aruba in a week, vs 90 days in the US. Or if the treatment wasn’t available in the US. Obviously the higher the deductable, the fewer patients, but I suspect it could be done in the $5m to $25m range.
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