MORE EVIDENCE OF ‘DEATH PANELS’ IN OBAMACARE: Rationing concerns based on age, race, ethnicity
Posted on January 4, 2013 at 1:50 AM EST
By Aaron Klein
The foundations for healthcare rationing and even so-called death panels may have already been quietly laid in largely unreported sections of President Obamaâ€™s healthcare legislation, KleinOnline has found.
There is also concern for preferential treatment based on race, ethnicity and so-called life preferences.
The Patient Protection and Affordable Care Act, commonly called Obamacare, called for the establishment of a Patient-Centered Outcomes Research Institute.
The new Instituteâ€™s purpose is to carry out â€ścomparative clinical effectiveness research,â€ť which is defined in the law as evaluating and comparing â€śhealth outcomesâ€ť and â€śclinical effectiveness, risks, and benefitsâ€ť of two or more medical treatments or services.
The purpose of the research is purportedly for the government to determine which treatments work best so that money is not spent on less effective treatments.
Such research was already previously funded to the tune of $1.1 billion in Obamaâ€™s 2009 â€śstimulusâ€ť package. That legislation first created a Federal Coordinating Council for Comparative Effectiveness Research .
Obamacare now allows for about $3.8 billion in additional funding for effectiveness research, with the establishment of the new Patient-Centered Outcomes Research Institute.
The Institute is to be governed by a â€śboardâ€ť to assist in identifying research priorities and establishing the research project agenda.
Also weighing in will be an â€śexpert advisory panelâ€ť of practicing and research clinicians, patients, and experts in scientific and health services research and health services delivery.
A section of Obamacare makes clear the Secretary of Health and Human Services may not use research data from the new Institute in a manner that treats the life of an elderly, disabled, or terminally ill individual as lower in value than that of an individual who is younger, non-disabled, or not terminally ill.
However, that dictate comes with a qualifier some many find concerning.
Obamacare contains largely unreported text that allows the Health Secretary to limit any â€śalternative treatmentsâ€ť of the elderly, disabled or terminally ill if such treatments are not recommended by the new research institute.
Reads that qualifier:
â€śParagraph (1) shall not be construed as preventing the Secretary from using evidence or findings from such comparative clinical effectiveness research in determining coverage, reimbursement, or incentive programs under title XVIII based upon a comparison of the difference in the effectiveness of alternative treatments
in extending an individualâ€™s life due to the individualâ€™s age, disability, or terminal illness.”
â€śParagraph (1)â€ť refers to the section that bars the Health Secretary from valuing the life of an elderly, disabled or terminally ill patient as lower than that of the younger orÂ non-disabledÂ patient.
The qualifier leaves the Health Secretary with the power to useÂ government-provided research data to determine whether â€śalternative treatmentsâ€ť are effective in extending the life of the elderly, disables, or terminally ill.
Healthcare rationing based on race, ethnicity?
Another section of Obamacare calls for the new Institute to study the effectiveness of treatment in â€śsubpopulationsâ€ť including â€śracial and ethnic minorities, women, age, and groups of individuals withÂ different comorbidities, genetic and molecular sub-types, or quality of life preferences.â€ť
The effectiveness of such research has been widely called into question.
In a 2009 study, the CATO Institute raised concerned about such government-funded research being politicized or influenced by lobbying.
â€śUnlike market-generated research, a federal comparative-effectiveness agency would be subject to political manipulation, which could block the generation of any useful research,â€ť wrote CATO.
Continued CATO: “Such researchÂ necessarilyÂ poses a direct threat to the incomes of pharmaceuticalÂ manufacturers, medical deviceÂ manufacturers, and millions of providers. If aÂ government agency produces unwelcomeÂ research, those groups will spend vast sums onÂ lobbying campaigns and political contributions to discredit or defund the agency.â€ť
During the â€śstimulusâ€ť debate, Sen. Jon Kyl, R-Ariz., fought the $1.1 billion spending on effectiveness research, spotlighting countries like Britain as cautionary tales.
“Think about this a moment,” Kyl said on the Senate. “Do you want Washington bureaucrats, such as those who brought you the AIG mess, making your health care decisions for you and your family?”
Currently, in the UK, the equivalent to Obamacareâ€™s Institute is the National Institute for Health and Clinical Excellence, or NICE.
The New England Journal of Medicine related that “NICE considers treatments cost-effective if their cost-effectiveness ratio is ÂŁ20,000 ($34,000) per QALY (quality adjusted life year).â€ť
A QALY is an extra year of â€śqualityâ€ť life expectancy added based on the treatment.
There were recent reports that NICE was refusing to fund four new treatments for kidney cancer because they only change a patientâ€™s life expectancy from six months to a year.
Andrew Dillon, NICE Chief Executive, commented on the denial of one drug for kidney cancer:Â Â â€śBefore we recommend any new treatment we have to be sure the evidence on how well it works is robust and that it is cost effective. We do not want to divert NHS funds to a treatment that costs more but doesn’t help people live longer.â€ť
Writing in Forbes last month, Sally Pipes, President of the Pacific Research Institute, slammed effectiveness research under Obamacare as a â€śrecipe for cook-book medicine, where the government can pressure doctors into prescribing treatments according to average results rather than an individual patientâ€™s needs and preferences.â€ť
With additional research by Brenda J. Elliott