President Obama says that “health-care decisions will not be made by government” while he sets up a new FEDERAL HEALTH BOARD to tell doctors what treatments they can offer and to whom and under what circumstances.
When the president says he guarantees the “same coverage” to people who like their current health-insurance policies, he really means that their current HMOs, insurers and doctors will be the ones to implement the protocols and instructions the GOVERNMENT hands down to them.
President Obama talks about countries that “spend less” than the U.S. on health care, but what he doesn’t want to explain is how they RATION care to do it. Take the United Kingdom, which is often praised for spending as little as half as much per capita on health care as the U.S.
Credit for this cost containment goes in large part to the National Institute for Health and Clinical Excellence, or NICE. The British officials who established NICE in the late 1990s pitched it as a body that would ensure that the government-run National Health System (NHS) used “best practices” in medicine.
The Guardian reported in 1998: “Health ministers are setting up [NICE], designed to ensure that every treatment, operation, or medicine used is the proven best. It will root out under-performing doctors and useless treatments, spreading best practices everywhere.” What NICE has become in practice is a RATIONING BOARD.
As health costs have exploded in Britain as in most developed countries, NICE has become the heavy that reduces spending by limiting the treatments that 61 million citizens are allowed to receive through the NHS. For example: In March, NICE ruled against the use of two drugs, Lapatinib and Sutent, that prolong the life of those with certain forms of breast and stomach cancer.
This followed on a 2008 ruling against drugs — including Sutent, which costs about $50,000 — that would help terminally ill kidney-cancer patients. In 2007, the board restricted access to two drugs for macular degeneration, a cause of blindness. The drug Macugen was blocked outright. The other, Lucentis, was limited to a particular category of individuals with the disease, restricting it to about one in five sufferers.
Even then, the drug was only approved for use in one eye, meaning those lucky enough to get it would still go blind in the other. NICE has limited the use of Alzheimer’s drugs, including Aricept, for patients in the early stages of the disease. Doctors in the U.K. argued vociferously that the most effective way to slow the progress of the disease is to give drugs at the first sign of dementia.
NICE ruled the drugs were not “cost effective” in early stages. Other NICE rulings include the REJECTION of Kineret, a drug for rheumatoid arthritis and AVONEX, which reduces the relapse rate in patients with Multiple Sclerosis.
Andrew Dillon, the chief executive of NICE, explained at the time: “When treatments are very expensive, we have to use them where they give the most benefit to patients.” The NICE board has also adopted a mathematical formula based on a “quality adjusted life year.”
While the guidelines are complex, NICE currently holds that, except in unusual cases, Britain cannot afford to spend more than about $22,000 to extend a life by six months. Why $22,000? It seems to be arbitrary, calculated mainly based on how much the government wants to spend on health care. That figure has remained fairly constant since NICE was established and doesn’t adjust for eithe