by Deane Waldman
U.N. Resolution 260 (III) — Convention on the Prevention and Punishment of the Crime of Genocide — was signed on December 9, 1948. It memorializes a worldwide consensus against state-sanctioned killing of people by groups. The convention protects “national, ethnical, racial or religious group[s].” The Convention forgot to protect a group called the expensives.
Nation-states are killing people based on their costliness, rather than their place of origin, skin color, religious commitment, political affiliation, or ethnicity. In order to cut healthcare costs, Great Britain and soon the U.S. will eliminate (kill) patients whose only crime is being expensive to treat.
Supporters of the ACA such as President Obama and Dr. Don Berwick openly and proudly said that ObamaCare was modeled after the British National Health Service (NHS). It is reasonable to expect that what the NHS has done in England will be done here. Additional acronyms that must be added to our body of evidence include NICE, IPAB, LCP, and WaSEPTS. Each will be explained.
Virtually all conversations about healthcare devolve quickly to cost-cutting, as though saving money were the purpose of healthcare. It isn’t. Healthcare’s true function is to have healthy, long-lived people. If cutting costs does not achieve that goal, healthcare is producing the opposite result from what we want.
You and I may talk about the “cost” of a car or a hernia repair, but only the manufacturer of a product or the provider of a service can cut true “costs.” Consumers and payers can only reduce their spending.
Consumers reduce spending through the free market, which balances supply and demand through competition and price variability. Third-party payers — private insurance and government agencies — achieve balance by decree rather than by using market forces. To reduce its healthcare spending, the government cuts payments for health care services. For expensive patients, it may choose to cut payments to zero. This translates to “no payment = no treatment.”
NICE (England) and IPAB (U.S.)
Sarah Palin’s “death panel” accusation on Facebook in 2009 turns out to have been true. The name of this death panel is IPAB (Independent Payment Advisory Board), an agency created by ObamaCare.
IPAB members are appointed. Its meetings are not open to public scrutiny. There is no oversight. IPAB is tasked with deciding which medical treatments are deemed “cost-effective” and which are not. IPAB then recommends to Congress that the former be authorized for payment and the latter not.
IPAB recommendations have the effect of automatic law. Congress can only make substitutions: deleting certain items and replacing them with others. Rejection of IPAB recommendations is not permitted under ObamaCare.
Effectively, IPAB is practicing medicine by making healthcare payment law. Doctors may advise the patient what is the best care, but the treatment that the patient actually gets or does not get is decided by IPAB.
IPAB was modeled on the British NICE (National Institute for Clinical Excellence). To project what IPAB will do to us, look at what NICE has already done to the British populace.
Kidney dialysis after 55 years of age and heart surgery after 65 have been classified “not cost effective” by the NHS. Result? If a British citizen is over those thresholds, he or she is…allowed to die (passively) by government mandate.
Though treatments are technically available and medically effective on individuals, they are withheld because of national budgetary considerations. This conundrum was brought before the British Court system.
The British High Court admitted that patients, providers, and the government were “impaled on the horns of a [moral and economic] dilemma.” It goes on to say that, given very real limitations in health care resources, the State has the right to do what it is doing: allowing people to die who could be saved.
As NICE has done to Britons, so IPAB will do to Americans: life or death by government decree. The title of this article is “Cutting Healthcare Costs by Killing Patients.” Killing is an active, not passive, act. While IPAB will allow you to die passively, WaSEPTS will actively kill you.
LCP (England) and WaSEPTS (U.S.)
A sign at the entrance to Auschwitz-Birkenau read, Arbeit Macht Frei, meaning “Work Shall Make You Free.” Posing as a work camp, people marked for death were taken to the showers, supposedly for cleansing. In fact, the “showers” were gas chambers.
Torn down in Poland, these showers were recently rebuilt in Liverpool, England and named the LCP (Liverpool Care Pathway). A sign at the entrance might read, “Cutting Health Care Costs.”