Many critics are busy complaining that President Obama’s healthcare reform plans are doomed to failure. It would be nice if they would just quit their whining and get back to caring for their polo ponies or something, because it’s clear that the plan will be successful. Think about it — as severely ill people die more quickly, costs will inevitably be cut.
It’s really quite simple. Take cancer treatment. If we can just make sure to treat cancer patients with older, cheaper, more ineffective treatments, then treatment will actually be more effective — at cutting costs as more cancer patients die. We not only save the cost of more expensive medication — we also save by relying on less expensive stays in hospices instead of more extended active treatments.
More importantly, if we can help patients die quickly now, then we can save on the cost of any future major illnesses they would’ve had that would have cost society a whole boatload of money. Basically, one severe potentially terminal illness is cheaper than two. Some cancer patients may try to demand more up-to-date, effective treatments, but society must obviously ignore their selfish desires to live.
The Obama plan is going to accomplish this with its billion-dollar investment in “comparative-effectiveness research.” This is a coup, because it sounds so rational and scientific. A sophisticated observer can see that it will be “comparatively effective” at reducing the rate at which new, more effective treatments are utilized. The kind of large, expensive studies required to prove that newer treatments are less effective at killing off patients will be so difficult to conduct that the newly created “Federal Coordinating Council for Comparative Effectiveness Research” (or FCCCER, pronounced faux care) will have cover for many years before it’s compelled to approve any new treatment.
Such is the excellent model provided by Great Britain’s National Institute for Clinical Excellence, known by the wonderful acronym NICE. Indeed it was “NICE” how the agency “regrettably” found last summer that four admittedly “clinically effective” lifesaving medications for kidney cancer were not “cost-effective uses of NHS resources.” NICE has been wildly successful in shortening the overall amount of time that the British medical system is forced to treat cancer patients. In Great Britain, survival rates after a cancer diagnosis range from 40.2 to 48.1 percent for men and 48 to 54.1 percent for women. The United States currently boasts an inefficiently high rate of 66 percent for men and 63 percent for women.
Of necessity, part of Obama’s plan is to get physicians focused on purchasing, integrating, and pulling their hair out over how to use fully computerized, government-approved medical records systems. Many physicians complain that these systems don’t work well in their practices, that they’re time consuming, and that they take time away from patient care. But these computer systems are absolutely essential in ensuring that physicians don’t try to practice medicine themselves and instead comply with the FCCCER’s dictates to use outdated treatments. Computer records will permit minute, constant scrutiny of physicians, who will be penalized for trying to use independent judgment in prescribing unapproved treatments.
An underappreciated part of the plan is the expected savings on Social Security benefit payments, if we can be more effective in not prolonging the suffering of those that could be terminally ill. It would be nice to see White House economists include such assumptions in their calculations to help bolster their argument for adoption of the President’s plans. That is the type of forward thinking that we need to sell this bill of goods to an American public so unsophisticated that they are worried about having the government fully take over one-seventh of the national economy during this time of economic distress and multi-trillion-dollar federal debt.
Mark Schiller, M.D., is a Senior Fellow at the Pacific Research Institute and a board member of the Benjamin Rush Society, a medical society that is dedicated to serving patients, not the government.