Revised Stimulus Plan Still Contains “Health Care Rationing” Provision – Where are you Senator Specter?

Despite his repeated assuarnces on TV that the provision would be removed from the stimulus bill – it still remains.

Isn’t your word any good Senator?

The language in question isn’t even remotedly related to “stimulating the ecomony” in the first palce – so the language/spending has no place in this bill.

This item should make its way through the Congress in the normal fashion and be subject to open and agressive debate – not smuggled past the American public in the dead of night.

A brief review of the provision follows – excerpted form the National Review On Line – the full article can be reviewed here:

The Stimulus and Health Care    [James C. Capretta]

The massive amount of spending in the so-called “stimulus” bill is startling, yes—but entirely predictable given the way the bill was set in motion.

There’s now $20 billion in new discretionary appropriations for HHS in the bill (not counting the HIT funding and Medicaid), and there is no real theme to any of it—other than more, pretty much across the board. $2.1 billion for Head Start. $0.5 billion for the NIH campus. $1.5 for university research facilities. $1.5 billion for NIH research grants. A $3.0 billion wellness fund. And on and on.

What’s just as troubling is the large number of far-reaching policy changes tucked away in the bill.

For instance, the Democratic majority is laying the foundation for government rationing of health care—and the public has heard virtually nothing about it.

The bill provides $1.1 billion for a new program of comparative effectiveness research. The idea is to study medical practice patterns, new products, and new technology to determine what is “cost effective.” In the UK, a similar program run by the National Institute for Clinical Evidence (NICE) is used to deny payment by the government for certain drugs and procedures that are said to be “cost ineffective.”

Democratic lawmakers will deny that rationing is their intent, but that is not credible. Why create a government program to study what’s cost effective if not to use the information to inform payment and coverage decisions? The problem is that this kind of research inevitably includes value judgments (how much is an extra year of life worth?) and interpreting the data is more art than science. In the wrong hands (like a distant government bureaucracy), so-called effectiveness research can be very dangerous indeed. (MCAULEYSWORLD: WORSE YET – MEDICAL DEVISE MANUFACTURERS OR MEDICATION RESEARCHERS CAN INFLUENCE THE SYSTEM WITH THEIR POLITICAL CONTRIBUTIONS AS HAS BEEN DONE IN THE PAST)

James C. Capretta is a fellow at the Ethics and Public Policy Center and a health policy and research consultant.

Stimulus Bill Raises Concerns Over Government Rationing of Health Care
Wednesday, February 11, 2009
By Fred Lucas, Staff Writer

( – Two provisions in President Barack Obama’s economic stimulus plan could give the federal government the authority to oversee the medical decisions made between doctors and patients, critics warn, which could result in the rationing of health care.
The bill provides $3 billion to computerize health records, a measure intended to cut costs and reduce medical errors. Language in the stimulus bill calls for “the utilization of an electronic health record (EHR) for each person in the United States by 2014.”
Further, the legislation also spends $1.1 billion to establish a Federal Coordinating Council for Comparative Effectiveness Research, which would serve as an umbrella group for all federal health programs, including Medicare, Medicaid, S-CHIP, and veterans’ care, with 15 members from various federal agencies making determinations about health care needs and cost-effective treatments. 
According to the bill, the secretary of Health and Human Services “shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use” by health care providers.
The bill also indicates that a doctor who is not a “meaningful EHR user” in terms of using patients’ health records to provide the most cost-efficient coverage could face penalties

This will require the establishment of the office of National Coordinator for Health Information Technology. The new office ‘‘provides appropriate information to help guide medical decisions at the time and place of care,” according to the language in the bill.

One problem critics note is that the electronic medical records will be mandatory.
“I am not against electronic records,” Betsy McCaughey, former lieutenant governor of New York, told “I am against coercing doctors to limit care. I certainly do not support vague guidelines. E-records are fine as long as they are not mandatory.”
McCaughey, an adjunct senior fellow at the conservative Hudson Institute, told there is “no question” that the goal is to ration health care to control costs. That is achieved, she said, by first putting every individual in a medical treatment database, and secondly by putting the new effectiveness council in charge of providing doctors with guidelines for how to most effectively treat those patients based on the data.
“The powers of the secretary of Health and Human Services are so vague as to raise constitutional questions,” McCaughey said. “The guidelines of what is cost effective could penalize doctors for providing too much care. Treatment decisions guided by the information in the database could determine if a doctor is providing inappropriate care, or excessive care, which would be defined as giving more care to one patient than other patients. This is harmful to patients.”

Though the bill, still under final revision in Congress, states that privacy of electronic health records will be protected, Sue Blevin, president of the Institute for Health Freedom, is concerned that there is not an opt-out for people who choose not to have their records computerized and entered into the national network.
“Without those protections, Americans’ electronic health records could be shared – without their consent – with over 600,000 covered entities through the forthcoming nationally linked electronic health records network,” Blevin said in a statement.

“Unless people have the right to decide if and when their health information is shared or whether to participate in research studies, they don’t have a true right to privacy.”

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