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This is such B.S. Trust virtually NO ONE who has M.D. after their name but who spends >90% of their time as a policy wonk. Further, this organization is based on outcomes assessments and “quality assurance” measures. This is at best a very faulty system of assessments that measures cost/benefit rations in terms of dollars spent per patient year of life saved etc. Patients aren't statistics. They are individuals, and each needs to be assessed and treated independently.

Part of working hard in life, getting an education, trying to live healthy, saving money, looking for a job with good benefits etc. is so that you can assure your family and yourself that you'll have a choice when it comes to treatment options.

Buttheads like Obama don't want anyone to have anything more than anyone else (unless you are a politician/lawyer/or work in Hollywood). So they think the best way to make sure that happens is to come up with standards that are applied universally. Inevitably those standards have to restrict care to some extent in order to keep the governments part of this cost from looking unsustainable right out of the box. The result is that they lower the standard of care for everyone, and the costs will be higher anyway. The reality is that everyone can get a great standard of care. There are plenty of ways to do this, but none of them are the ways that are being proposed now.

Here's a real life example in which outcomes measures would likely change management based on cost/benefit ratio.

Th traditional thinking about suspected appendicitis is that it is better to have a 10% false operation rate (i.e. normal appendix) than to miss anyone with appendicitis. It would likely be very hard to justify this based purely on outcomes measures and cost/benefit ratios. So to save on costs one might institute a higher bar to jump over before going to surgery. This would likely reduce the number of unnecessary operations, but would also increase the number of those that get missed that really needed surgery. If you're one of those who didn't get operated on and your appendix ruptures, you as an individual will pay the price for being on the wrong side of a statisticians equation.