Want to know what universal healthcare will look like down the road? Look at what’s happening today in Medicare. From WSJ, How Washington Rations
ObamaCare omen: a case study in ‘cost-control.’
Desperate to prevent medical costs from engulfing the federal budget, the program’s central planners decided last week to deny payment for a new version of one of life’s most unpleasant routine procedures, the colonoscopy. This is a preview of how health care will be rationed when Democrats get their way.
At issue are “virtual colonoscopies,” or CT scans of the abdomen. Colon cancer is the second leading cause of U.S. cancer death but one of the most preventable. Found early, the cure rate is 93%, but only 8% at later stages. Virtual colonoscopies are likely to boost screenings because they are quicker, more comfortable and significantly cheaper than the standard “optical” procedure, which involves anesthesia and threading an endoscope through the lower intestine.
What’s Medicare’s beef with this?
…The problem for Medicare is that if cancerous lesions are found using a scan, then patients must follow up with a traditional colonoscopy anyway. Costs would be lower if everyone simply took the invasive route, where doctors can remove polyps on the spot. As Medicare noted in its ruling, “If there is a relatively high referral rate [for traditional colonoscopy], the utility of an intermediate test such as CT colonography is limited.” In other words, duplication would be too pricey.
That’s the kind of result you can expect from comparative effectiveness research, which looks at clinical data in the abstract and concludes which one-size-fits-all treatment is cheapest to the system. Patient comfort is not cost-effective in these minds.
The problem is that what “works best” isn’t the same for everyone. While not painless or risk free, virtual colonoscopy might be better for some patients — especially among seniors who are infirm or because the presence of other diseases puts them at risk for complications. Ideally doctors would decide with their patients. But Medicare instead made the hard-and-fast choice that it was cheaper to cut it off for all beneficiaries. If some patients are worse off, well, too bad.
It’s not about what’s best for individual patients. Socialized healthcare is all about cost and power, and don’t let those liars in Washington convince you otherwise.