Most objections to the Affordable Health Care for America Act, the federal health care legislation that narrowly passed the U.S. House on November 7th, relate to money. Fair enough.
But one section relates to something far more precious than money-your life. Title IV of the Act mandates a Center for Comparative Effectiveness Research.
The authority prescribed to this Center is truly frightening: it shall act “with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.”
In other words, your medical destiny rests with some unknown, distant, third party residing in some Washington D.C. office, consisting of three officers and “16 additional members.” I hope they’re in a good mood when they take up your treatment.
We have heard endlessly that the Obama administration wants to reduce health care costs. The Center for Comparative Effectiveness can achieve that, through the methodologies of one-size-fits-all and “best practices.” That’s fine-unless you’re an individual.
Drs. Jerome Groopman and Pamela Hartzband, on the faculty at Harvard Medical School, have warned that “rigid and punitive rules for broadly standardized care for all patients often break down. Human beings are not uniform in their biology.” Tell that to the cost-cutting Center.
Treating you with “best practices” sounds good, right? But even more alarming, Drs. Groopman and Hartzband report on a study of “how long it takes for conclusions derived from clinical studies about drugs, devices, and procedures to become outdated. Within one year, 15 of 100 recommendations based on ‘best evidence’ had to be significantly reversed; within two years, 23 were reversed, and at 5 ½ years, half were contradicted.”
In other words, “best practices” could kill you.
Drs. Groopman and Hartzband conclude ominously: if the House bill, which does not set limits on what “best practices” federal officials can limit, becomes law, “bureaucrats could well write regulations mandating treatment measures that violate patient autonomy.”
The health care Act codifies the authority and power of a panel of 19 people to control all aspects of your health care.
For seniors, the Act is especially portentous. Not only could the panel pull the plug on grandma, it might not even insert it in the first place. We know this to be the case with the agency in control of comparative effectiveness research in England, the National Health Service, a model the panel of 19 could emulate. We can’t be certain of this, but it’s too risky to codify the possibility. Government should never be given the potential of such unlimited power.
For seniors, too, we must remember that White House health care advisor Dr. Ezekial Emanuel, brother to White House Chief of Staff Rahm Emanuel, published in January, 2009, a chart illustrating his ethical “Principle for Allocation of Scarce Medical Interventions,” in which he regards old age as the relatively least valuable “life stage.” It could be a bad time to be old.
C.S. Lewis once observed that most bad acts are performed by officials “with clean fingernails working in well-lit offices.”
Ronald L. Trowbridge, Ph. D. is a resident of The Woodlands and a Visiting Research Fellow at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin. Dr. Trowbridge formerly served as vice president of Hillsdale College in Michigan.