ORWELLIAN POLICIES DOMINATE HEALTH 'CARE' LEGISLATION
In a speech on the Senate floor, Senator Pat Roberts (R-KS) reveals sections of the Democratic party so-called health 'care' bill that will ensure that elderly get more managed and less care and medication than they do now.
Through new or existing commissions and agencies which are empowered, the health care legislation, once enacted, will follow the philosophy of those who say those over 50, 60, 70 and up are not worth the medicine, treatments and care that those of younger age should have. That is how the Democrats can say these health insurance bills save money. They take it from one group and give it to another. These actions will be a matter of law and regulation and your doctor, if you manage to get the same one, would have to follow the law with regard to what he can do for you.
Congressional Record November 20, 2009; [Pages: S11888=S11889]
Speech of Senator Pat Roberts (R-KS)
"... this is the health care bill. There are a lot of things in this bill that I object to. The $2.5 trillion cost, the 24 million people still left uninsured, the unconscionable $ 1/2 trillion cuts to Medicare and our senior citizens, with another $ 1/2 trillion in job-killing tax increases, in my view, the stunning assaults on liberty, and the Orwellian policies making health insurance even more expensive--any one of these things would make me vote no on this bill.
But one issue has me troubled the most; that is, the issue of rationing. We have several of my colleagues here who will speak to this subject, and we will engage in a colloquy. I don't think this issue has sunk in with the American people and, for that matter, the media.
I want everyone to understand something. This bill aims to control the government's spending by rationing your access to health care. Let me repeat that. This bill aims to control the government's spending by rationing your access to health care.
There are at least four government entities--we decided to call them ``the rationers''--that will stand between you and your doctor, and these four entities are represented by the four walls on this chart behind me blocking the doctor-patient relationship. You can see a pair of senior citizens and with frowns on their faces and then we have the rationers.
We have an institute, a board, a center, and a task force, some of which are in place now and some are not. But every Senator should know about them and every health care recipient or especially senior citizen should know about them.
Senator Reid's bill establishes the Patient-Centered Outcomes Research Institute--that is the first wall--to conduct something called comparative effectiveness research, or CER, which is research that compares two or more of the same treatment options for the same condition to see which one works best. That sounds like a good idea. But, unfortunately, when CER is conducted by a government under pressure to meet a budget, it can be manipulated in some very sinister and counterproductive ways, as has been demonstrated by the United Kingdom's CER Institute. They call theirs the National Institute for Health and Clinical Excellence. The acronym is NICE, but NICE is not very nice in Great Britain.
NICE is notorious for delaying or outright denying access to health care treatments based on CER that takes into account the cost of the treatment and the government's appraisal of the worth of the patient's life or comfort. Some of the more shocking CER decisions handed down by NICE over the years include: restricting access to drugs to save seniors' vision from macular degeneration until the patient is blind in one eye, inconceivable; denying access to breakthrough treatments for aggressive brain tumors; and refusing to allow Alzheimer's therapy until the patient deteriorates.
The Patient-Centered Outcomes Research Institute will be the American version of NICE using CER to save the government money by rationing your health care.
Over the past few months, I have offered several amendments, along with Senators KYL, COBURN, and ENZI, to protect American patients from NICE-style rationing, to prohibit this bill from valuing cost containment over the care of patients. Unfortunately, they have all been voted down on party-line votes in the HELP Committee, the Finance Committee, and previously on the floor.
Let's move to the independent Medicare advisory board. That is the second wall between patients and their doctor. The Obama-Reid bill establishes a new independent Medicare advisory board, an unelected body of 15 experts who will decide Medicare payment policy behind closed doors with minimal congressional input--something that is happening all too often around here.
Although the bill says this anonymous board shall not include any recommendation to ration health care, what else would you call denying coverage for Medicare patients based on cost? That is what this board will do--deny payment for knee replacements or heart surgery or breakthrough drugs, all to achieve an arbitrary government spending target. I don't know what you call that, but I call it rationing.
Also notice that this board will necessarily ration access to health care based on age and disability. Its payment policies will only affect the elderly and disabled who receive Medicare.
What will be a patient's recourse if Medicare refuses to pay for an innovative new therapy that could save or prolong their life? These are the reasons why the Wall Street Journal has dubbed this board the rationing commission.
Let us move now to the CMS innovation center. We come to the third wall between the doctor and patients. The Centers for Medicare and Medicaid Services, or CMS--and every provider knows what that is--administers the Medicare Program upon which 43 million Americans rely. That is almost 15 percent of the population. CMS already rations care. This has already been referred to by Senator Thune and others in their comments on the floor. It is not authorized to but it does so indirectly through payment policies that curtail the use of virtual colonoscopies, certain wound-healing devices, and asthma drugs. In fact, courts recently had to intervene to prevent CMS from rationing a relatively expensive asthma drug in Medicare because rationing is currently against the law.
However, the Reid bill establishes a new CMS innovation center which will, for the first time, grant CMS broad authority to decide which treatments to ration.
Let's go now to the U.S. Preventive Services Task Force. That is the last one right here. The U.S. Preventive Services Task Force is yet another panel of appointed experts--a lot of those in this bill--who make recommendations on what preventive services patients should receive.
Currently, the task force recommendations are optional, but the Reid bill bequeaths this unelected and unaccountable body with new powers to determine insurance benefit requirements in Medicare, Medicaid, and even in the private market.
The task force has already revealed the types of recommendations it will be making. Just last week it decided to reverse its longstanding recommendation that women get regular, routine mammograms to detect breast cancer starting at age 40. One has to wonder if the task force's abrupt about face has anything to do with the fact that the Federal Government's financial responsibility for these screenings and for the health care needs they could potentially reveal will be greatly expanded if this health care reform bill passes.
In the words of one prominent Harvard professor:
"Tens of thousands of lives are being saved by this screening, and these idiots want to do away with it. It's crazy. It's unethical, really."
The outcry from oncologists, the American Cancer Society, the American College of Radiology and breast cancer survivors and families across the country has forced our Health and Human Services Secretary, Kathleen Sebelius, to backpedal away from the task force recommendation, saying they do not affect government policy. As a matter of fact, Secretary Sebelius said: Let you and your doctor make the decision.
But this bill relies on the task force's recommendation, some 14 times throughout the legislation, to set benefits and determine copayments and make grant awards. So contrary to the Secretary's assertion, if this bill passes, the recommendation of the task force will become government policy. Not only that, it will be forced onto private insurers as well.
Some may ask, after my comments: Why so cynical? Why not trust these tools that they will only be used for good, to advance medical science and patient care. I hope that is the case.
To those folks I answer by showing this chart over here by Dr. Ezekial Emmanuel and his ``complete lives system.'' As many of you know, Dr. Emmanuel is the brother of White House Chief of Staff Rahm Emmanuel. He is a bioethicist, one of those special advisers to the President. Perhaps he could actually be the rationing czar.
Dr. Emmanuel has published very disturbing ideas on how to ration care, which could be summed up by this ``Brave New World'' humpback whale graph we have here, along with aging groups of the population.
Dr. Emmanuel's Complete Lives System--something that sounds a little bit like a cure-all elixir sold out of Del Rio, TX--basically works off the premise that the older you are, the more you have lived and, therefore, the less you deserve in terms of health care.
I would like to point out that the average age of a Senator is 62--just something for all of you to think about, as you look at this chart depicting the Complete Lives System.
As shown on this chart, if you are 10 years old, you are doing pretty good right here. Twenty years old, that is when you think you are bulletproof and you do not want insurance, but you have a lock under this plan. Thirty years old, you are in pretty good shape. Forty, here comes the roller coaster. Fifty, you are in trouble. Sixty, you might as well forget it. Seventy, well, you are off the chart.
President Obama has clearly listened to Dr. Emmanuel's counsel. Remember his observation in an interview this summer that, as patients get closer to the end of their life: ``Maybe you're better off not having the surgery, but taking the shots and the painkiller'' instead.
Well, as someone who falls toward the end of Dr. Emmanuel's bell curve here--as shown over here on this chart--this type of thinking is unbelievable: Telling someone they cannot have a knee replacement because they are too old? How old is too old, according to Dr. Emmanuel?
The Wall Street Journal reported on the age rationing that occurs in Canada. In that country, apparently 57 is too old for hip surgery. Perhaps they can drive south and find care right here in the United States. But I am not sure where they will go if this bill passes.
The White House may complain that I am taking Dr. Emmanuel's musings out of context. My response to that is this: This is the context right here.
This is how the government will contain costs. All these policies must be viewed through the prism of these ideas: This institute, this board, this center, this task force follows that blueprint.
This is the goal: to save the government money by rationing care, by basing that rationing on some pseudoscientific graph such as this. At least in the United Kingdom they are honest about it.
These are the tools of rationing. These tools will restrict your ability, and your family's ability, to get a knee replacement or a breakthrough cancer drug or treatment for Alzheimer's or a mammogram.
They will destroy the American health care system--the best health care system in the world. And they are the main reason why I will vote no on this bill."