The New York Times Softens the Ground for Utilitarian Health Care Rationing.
The New York Times has noticed the crass utilitarianism that permeates the UK's NHS--run by the Orwellian-named bioethics board National Institute for Health and Clinical Excellence (NICE)--and seems to be softening the ground for our accepting similar utilitarian overlords here. From the story:
When Bruce Hardy's kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British, and the British health authorities refused to buy the medicine. His wife has been distraught.If an HMO did such a thing, the Times would never stop screaming. But with the prospects of a nationalized health care system growing, attitudes at the Gray Lady are apparently changing, with the term "evidence based" health care as the euphemistic honey to help the bitter medicine go down.
If the Hardys lived in the United States or just about any European country other than Britain, Mr. Hardy would most likely get the drug, although he might have to pay part of the cost. A clinical trial showed that the pill, called Sutent, delays cancer progression for six months at an estimated treatment cost of $54,000. But at that price, Mr. Hardy's life is not worth prolonging, according to a British government agency, the National Institute for Health and Clinical Excellence. The institute, known as NICE, has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen's life.
Lest you think such policies will never happen here, it is already being advocated by many of our betters among the intelligentsia:
At the present rate of growth, medical costs will increase to 25 percent of the nation's gross domestic product in 2025 from 16 percent, with half of the increase coming from new drugs and devices, according to the Congressional Budget Office.Make no mistake: This is the opening round of the coming debate about national health care that will, if it succeeds, put utilitarian bioethicists in position of tremendous power over all of our lives. It is up to us to make sure it does not happen.
To arrest this trend, the United States needs to adopt at least some of NICE's methods, said Dr. Mark McClellan and Dr. Sean Tunis, who served earlier in the Bush administration as, respectively, administrator and chief medical officer of the Center for Medicare and Medicaid Services. Dr. Tunis said he spent a lot of time in government "learning about NICE and trying to adopt the processes and mechanisms they used, and we just couldn't."
That's because the idea of using price to determine which drugs or devices Medicare or Medicaid provides has provoked fierce protests. But Dr. McClellan said the American government would soon have no choice.


16 Comments:
This makes me sick. And, of course, the NYT will convienently find a way to blame conservatives for healthcare rationing-notice that they cited Bushe's healthcare manager, rather than someone affiliated with the Obama camp. The reason I care about this distinction is that it enables further use of leftism to spread euthanasia and futile theory as leftism is repeatedly portrayed as compassionate vs. conservatism, portrayed as cold and unfeeling. It doesn't matter which side does it-it's bad.
On the Orwelian thing-I was re-reading 1984 the other day and it occured to me that our society has adopted reversals that are similar to the ones Orwell describes-"freedom is slavery, ignorance is strength," etc.
In respect to disabled people and their loved ones, our culture is now permeated with the belief that:
Murder is love
abortion is compassion
sacrifice is weakness
SAFEpres: Well said.
Ok, it's up to us to stop it. HOW?
Personally, I think it's going to take something big-like the Freedom Rides and Marches of Martin Luther King-only for disabled people and against medical rationing-for things to change. The disabled community and its allies have to become more visible, so that the media and others can not help but take notice and make some changes.
Wesley, I agree that all of us need to be involved, but I'm afraid I don't know what to do. What do you recommend we do now?
That's right, what do we do now?
I agree about a big demonstration; reminds me of Not Dead Yet's demonstration and shouting "Not.Dead.Yet!" which made an indelible permanent impression on me. That has to be repeated over and over. In addition, there are the elderly. In addition, there are those who will be elderly in the future and have to be woken up to what awaits them. In addition, there are the families and friends of those who have been removed from life support against their will and over their loved ones' objections. In addition, there are those who think "living wills" are a great idea and haven't figured out that they can't possibly know exactly what the circumstances would be if they ever were in the situation, and how they might feel and what they might want then. Those who have lost loved ones to removal of life support over their objection have to speak up and go public, very loudly, and they need to be located and organize. Talk show appearances/interviews, TV, radio, and print ads, billboards -- and money has to be raised for all that. Picketing, demonstrations in front of hospitals and "think tanks" and other organizations that pull plugs and promote the death culture, with publicity. Lobbying, letters, emails, pressuring of legislators. Making it an issue in elections, political candidates who take up the cause, campaign ads noting that the politician voted for/sponsored such and such bill. Bringing examples to public attention dramatically. Bringing to public attention the issue of how the elderly are treated in hospitals, and pointing out that malpractice cases are hard to bring when the victim is elderly because the awards are smaller based on future life expectancy, with the result that hospitals know that they can get away with it. I think that the baby-boomer generation would be apt to make a fuss if it was made more aware of what is in store for it when it becomes geriatric patients. Bringing to public attention that people, particularly geriatrics, often end up on "life support" unnecessarily, simply as the result of disorganized, negligent "care" in hospitals. Have to change attitude of the medical professional, as well as society in general, to the elderly. The best way to cut costs and prevent "waste of use of equipment" and free up beds when it comes to life support is to prevent people from ending up on life support unnecessarily as the result of negligence, and to accomplish that, hospitals have to be held accountable, change their attitudes, and be better organized. Attitudes have to be changed at the stage of medical education in medical schools and continuing medical education, and in the public at large at well. Arrogance in doctors and in the medical profession no longer can be nurtured or tolerated. It's going to take more than individual medical malpractice suits. People have to make a fuss, and there are plenty of people who have had bad experiences, lost loved ones, etc., to do that. They just have to be mobilized and society has to be made aware that better is possible, and that they deserve better, and that doctors work for them and do not belong on pedestals. Insurance companies have to be influenced somehow. Those who pay for insurance, and the many who do not carry insurance and have to pay for their own care, have to be given the confidence to realize that they are entitled to make a fuss when they do not get their money's worth. This economy is a plus in that regard, including re employers who have to pay for their employees' insurance. Nurses, who tend to have more sense than doctors, have to be encouraged to speak out; the shortage of nurses puts them in a stronger position to do that than they would be in if there were not a shortage of them. Hospital administrators have to be reminded firmly that patients and their loved ones are consumers who won't put up with disrespect and murder. "Elder law" attorneys and social services types have to be re-educated. Professional organizations in law, medicine, social work, etc. have to hear emphatically from the public. Well, those are just a few ideas off the top of my head, and they are not even the tip of the iceberg of what can and must be thought up, and done.
p.s. My focus is on the elderly because of what my experience has been. What I've suggested also applies to the disabled, obviously, and the public has to be made aware that just as they one day will be geriatric, at any moment any one of us might become disabled via accident and/or illness. The more people learn to relate what they normally don't think of to themselves, the less apt they will be to be willing to deny life to others.
An ad campaign that tells people what it really will mean to them when they become vulnerable, in what situation they personally could end up, could help defeat Obama's proposed plan. People are not in the habit of thinking. Things have to be pointed out to them in such a way that they can relate the issues to their own lives. They have to be woken up. Stories such of those of the young man in Texas who had been in a motorcycle accident, was declared brain-dead, and woke up just as his organs were about to be "harvested" and cases such as Terry Schiavo's have to be not only news items, but related to the lives of the audience, just as individual lawsuits are not enough; they have to be understood as not the "exception" that happened to someone else, but the possibility that could happen to us. Science and medicine, of course, will accuse those doing what has to be done here of ignoring what's "best for" people, trying to hamper scientific progress, fear-mongering, appeals to emotion, etc. Tough. If enough people are woken up the greed of science and medicine, and the death culture, will be shown to be what they are.
We need more Pendragons out there to battle the Mass Media. Problem - Mass Media might print a few Letters to the Editor but those don't really hit home. Suggestion - alternative newspapers? I love the Houston Press, which comes off as being edgy and urbane, and maybe that's what it'll take to appeal to the masses to read about where they're being steered wrong. This blog is a good starting place, too. But we need a lot more people out there writing and making others think.
I agree. There need to be billboards and constant TV ads that put in people's faces, "It could happen to you." Martin Luther King's nonviolence doctrine, large peaceful marches, etc., are good ideas, but for something as literally life-and-death as this, I think some drama, civil disobedience, and violent (not against any people or animals, of course), emotional demonstrations of outrage are consistent with the gravity of the issue, appropriate, and called for; there are enough people with sense to ratify them, and it could bring others more in touch with themselves, force them to think, and turn them away from the death culture. We are living in a state of oppression that is about to turn into an outright dictatorship if we don't do something soon, and part of that oppression is people feeling there is nothing they can do, they can't speak up, etc. What touches them viscerally, and the example of others shouting out loud, can give them the courage to wake up and fight along with those already fighting. Whatever supports the death culture has to be removed, strand by strand. Money, ignorance, stupidity, complacency, living wills... In fact a mass public demonstration of people burning their "living wills" would, I think, be effective.
I personally am going to have my second annual vigil against futile care policies on December 31st. Generally, this entails people or groups of people going outside in a public place with candles and/or signs talking about futile care and silently (or not so silently)
witnessing to its impact on people. So, that's one idea.
SAFEPRES: Where do you do this? Do they have signs with pictures of people to whom it has happened who wanted to continue to live?
Speaking of signs, the one cited in this section that says "Be Nice Or Leave" reminds me of the signs in the hospital that insisted on killing my mother that say, in effect, if you don't behave, we won't treat you...
I am based in MA, usually. Because my group is very small, I have tried to focus on encouraging individual people to design their own vigils and organize peaceful demonstrations in public places on New Years Eve. If you want more info on last year's vigil, you can go to http://studentsandcitizensagainstfutileethics.org. I'm sorry that I don't have more specific info, I'm still working on organizing a group outside of the website itself and membership tends to be scattered among a few people in the US that I keep in regular contact with or who help with the website. I'm hoping that more people will get involved as SAFE becomes more organized.
SAFEpres: Thanks. I am going to look at the SAFE website.
Ianthe-also, if you want to get in touch, there should be a link on the website.
SAFEpres: Thanks.
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