Combs Spouts Off

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Some animals are more equal than others

Posted by Richard on July 19, 2010

David Catron at Pajamas Media (emphasis added):

If you’re like most Americans, you had probably never heard of Donald Berwick before July 7, when President Obama installed him as Administrator of the Centers for Medicare & Medicaid Services (CMS). And, unless you’re a health policy wonk, the news that Obama circumvented the normal Senate confirmation process with a recess appointment probably elicited no response beyond a briefly raised eyebrow and a stifled yawn. But this CMS decision deserves another look. Dr. Berwick has been granted the power to reach out and touch you in ways undreamed of by higher profile appointees like Elena Kagan. Whether you’re paying attention or not, he will have a profound impact on the quality of your life.

CMS isn’t some Beltway backwater with a few clerks processing Medicare and Medicaid claims. It’s a gigantic bureaucracy with thousands of employees, a budget larger than the Pentagon’s, and the authority to dictate treatment standards for the nation’s hospitals, nursing homes, and clinical laboratories. It also administers policies that directly affect how many physicians are available to provide medical treatment for you and your family. Moreover, Berwick isn’t just another political hack or Ivy League gasbag. He’s an experienced, sophisticated administrator who knows how to get what he wants. And what he wants for Medicare, Medicaid, and eventually the entire U.S. health care system is rationing.

Unlike his boss in the White House, Dr. Berwick has made no secret of his views on this issue, and has never avoided the “R” word. In a 2009 interview for Biotechnology Healthcare, for example, Berwick praised the heavy-handed rationing methods of Britain’s National Institute for Health and Clinical Excellence (NICE) and said, “The decision is not whether or not we will ration care; the decision is whether we will ration with our eyes open.” Unfortunately, the interviewer failed to ask the obvious follow-up question: “Who’s we?” It turns out that what the good doctor really means when he says “we” is “you.” For himself and his wife, he has arranged to opt out of the health care system he plans to impose on the hoi polloi.

But before we get to that, it’s important to flesh out what Berwick has in mind when he talks about rationing. His praise of NICE is significant. The apparatchiks of that soulless health care bureaucracy have, quite literally, calculated how much money a single year of the average Brit’s life is worth (about $45,000). And if a patient needs treatment or drugs that exceed that amount, he’s out of luck. Consequently, the British news media are full of stories like those of Jack Rosser and Albert Baxter, both of whom were denied cancer drugs. The former is only alive today because an American benefactor came to his rescue. The latter killed himself when informed that he would not receive treatment.

But Dr. Berwick won't have to worry about his life not being judged worth saving. His life is more valuable than yours and mine, so the chilling calculus he plans to apply to us won't apply to him. Read the whole thing.

We are no longer citizens, we are subjects. And they are no longer our servants, they're our masters rulers.

(HT: Instapundit)

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3 Responses to “Some animals are more equal than others”

  1. Hathor said

    I don’t know what happens in Medicaid, but I can tell you now that there is and has been that type of rationing in Medicare. Why do you think all those adds are for, selling supplemental insurance? There are some prescription programs, that do not cover biomeds.

    I really wish someone who has used the system would speak on it, someone who actually knows how it works.

  2. rgcombs said

    Everything of value is “rationed” in the broadest sense of that word. All goods are scarce, and there is never enough of everything to satisfy everyone. And yes, existing government health care programs have rules about what’s covered and what isn’t — as do private insurance plans. That’s because the people paying the bills don’t have infinite resources.

    The same situation would exist if the government controlled the food supply, paid for our groceries, and decided who got what to eat: you’d be told you could have all the tofu, rice and vegetables you want, and four portions of chicken per week, but no steaks or portobello mushrooms. Fortunately, groceries aren’t (yet) a “basic human right” provided by the government (they tried that in the Soviet Union; the results weren’t pretty).

    The differences between the situation today and what’s coming under ObamaCare and Berwick that prompted my post are two-fold:

    (1) Berwick’s goal is rationing with a vengeance, where he and his boards and commissions will calculate ”your “value to society” ”in order to determine whether your life is worth preserving. It will make the rationing taking place today seem mild and benign.

    (2) Berwick’s rationing won’t apply to Berwick — and I’m sure it won’t apply to his fellow members of the ruling elite. Thus my title, which is from Orwell’s ”Animal Farm”.

  3. Hathor said

    “(1) Berwick’s goal is rationing with a vengeance, where he and his boards and commissions will calculate your “value to society” in order to determine whether your life is worth preserving. It will make the rationing taking place today seem mild and benign. “

    I think to some, with certain diseases, already feel this is how their health care is being determined.

    I know I have felt like that when I have had to sign a statement accepting responsibility for a test that Medicare deems unnecessary, but is medically necessary because of the medication I take. We are not speaking of the usual suspects of side effects, but some that approach dangerous levels. But you know I might be one of those who abuse the system, I’m invisible. There’s no humanity in those decisions. I am one of the fortunate people to have other insurance, simply because I was still able to work and worked where there were health benefits.

    I do see more rationing coming and I don’t think any one person is going to be responsible for it, as it has been happening the last few decades. I think you are looking for a scapegoat for some reason, is it because you are getting closer to when you think you will really have to negotiate the health system. If so, welcome to my world.

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