by Kerry Thomas
February 9, 2009
Health care professionals and anyone who uses the American
health care system should pay particular attention to provisions in the
“stimulus bill” now under consideration in Congress.
Beginning on page 434 of the 660 page American
Recovery and Reinvestment Act of 2009 you will find Division B – Other
Provisions. Title IV is called
Health Information Technology.
This article explains the highlights (or lowlights) of these
provisions:
Ruin Your Health
With the Obama Stimulus Plan
by Betsy McCaughey
February 9, 2009
(Bloomberg) --
Republican Senators are questioning whether President Barack Obama’s
stimulus bill contains the right mix of tax breaks and cash infusions to
jump-start the economy.
Tragically, no one from either
party is objecting to the health provisions slipped in without
discussion. These provisions reflect the handiwork of Tom
Daschle, until recently the nominee to head the Health and Human
Services Department.
Senators should read these
provisions and vote against them because they are dangerous to your
health. (Page numbers refer to H.R.
1 EH, pdf version).
The bill’s health rules will
affect “every individual in the United States” (445, 454, 479). Your
medical treatments will be tracked electronically by a federal system. Having
electronic medical records at your fingertips, easily transferred to a
hospital, is beneficial. It will help avoid duplicate tests and errors.
But the bill goes further.
One new bureaucracy, the National
Coordinator of Health Information Technology, will monitor treatments
to make sure your doctor is doing what the federal government
deems appropriate and cost effective. The goal is to reduce costs and
“guide” your doctor’s decisions (442, 446).
These provisions in the stimulus
bill are virtually identical to what Daschle prescribed in his 2008 book,
“Critical: What We Can Do About the Health-Care Crisis.”
According to Daschle, doctors have to give up autonomy and “learn to operate
less like solo practitioners.”
Keeping doctors informed of the
newest medical findings is important, but enforcing uniformity goes too far.
Hospitals and doctors that
are not “meaningful users” of the new system will face
penalties. “Meaningful user” isn’t defined in the bill. That will be
left to the HHS secretary, who will be empowered to impose “more stringent
measures of meaningful use over time” (511, 518, 540-541)
What penalties will
deter your doctor from going beyond the electronically delivered protocols
when your condition is atypical or you need an experimental treatment?
The vagueness is intentional. In
his book, Daschle proposed an appointed body with vast powers to make the
“tough” decisions elected politicians won’t make.
The stimulus bill does that, and
calls it the Federal Coordinating Council for Comparative Effectiveness
Research (190-192).
The goal, Daschle’s book explained, is
to slow the development and use of new medications and technologies because
they are driving up costs. He praises Europeans for being more willing to
accept “hopeless diagnoses” and “forgo experimental treatments,” and he
chastises Americans for expecting too much from the health-care system.
Daschle says health-care
reform “will not be pain free.” Seniors should be more accepting of
the conditions that come with age instead of treating them.
That means the elderly will bear the brunt.
Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).
The Federal Council is modeled
after a U.K. board discussed in Daschle’s book. This board approves or
rejects treatments using a formula that divides the cost of the treatment by
the number of years the patient is likely to benefit.
Treatments for younger patients
are more often approved than treatments for diseases that affect the elderly,
such as osteoporosis.
In 2006, a U.K. health board
decreed that elderly patients with macular degeneration had to wait until they
went blind in one eye before they could get a costly new drug to save the other
eye. It took almost three years of public protests before the board reversed
its decision.
If the Obama administration’s
economic stimulus bill passes the Senate in its current form, seniors in the
U.S. will face similar rationing. Defenders of the system say that individuals
benefit in younger years and sacrifice later.
The stimulus bill will affect
every part of health care, from medical and nursing education, to how
patients are treated and how much hospitals get paid.
The bill allocates more
funding for this bureaucracy than for the Army, Navy, Marines, and Air
Force combined (90-92, 174-177, 181).
Hiding health legislation in
a stimulus bill is intentional. Daschle supported the Clinton
administration’s health-care overhaul in 1994, and attributed its failure to
debate and delay.
A year ago, Daschle wrote that the
next president should act quickly before critics mount an opposition. “If that
means attaching a health-care plan to the federal budget, so be it,” he said.
“The issue is too important to be stalled by Senate protocol.”
On Friday, President Obama called
it “inexcusable and irresponsible” for senators to delay passing the stimulus
bill. In truth, this bill needs more scrutiny.
The health-care industry is the
largest employer in the U.S. It produces almost 17 percent of the nation’s
gross domestic product. Yet the bill treats health care the way European
governments do: as a cost problem instead of a growth industry. Imagine limiting
growth and innovation in the electronics or auto industry during this
downturn. This stimulus is dangerous to your health and the economy.
Betsy
McCaughey is former lieutenant governor of New York and is an adjunct
senior fellow at the Hudson Institute. The opinions expressed are her own. Contact Betsy McCaughey at Betsymross@aol.com