13. Comparative Effectiveness

Let’s talk about another form of healthcare rationing: Comparative Effectiveness. The
concept of Comparative Effectiveness puts a dollar value on each year of a person’s remaining
life. That number is multiplied by the number of years a person is expected to live, depending
upon their diagnosis or illness. If you are diagnosed with cancer, for instance, and the cost of
your treatment exceeds that number, guess what? You don’t get the treatment. None of it. If
you have cancer, chances are you will suffer and die from it.

For years, Comparative Effectiveness has been used to control healthcare costs in England.
A colleague of mine did part of his neurosurgery residency in England several years ago. An
otherwise healthy lady slipped and fell on the steps of the hospital, hitting her head badly.
She was unconscious and brought into the ER. This doctor could tell that she was bleeding
into her head and that an emergency surgery needed to be done to save her life. He began
preparing her for surgery, when a hospital administrator told him to stop. Apparently, she
was 71 years old, over the age limit for neurosurgery according to their national healthcare
guidelines. So instead of going to the Operating Room for life-saving surgery, she was taken to
the Recovery Room where she slowly died over the next 3 days. 71 years old. Think this can’t
happen in the U.S.? Think again!

In 2010, while the US Senate was in recess, President Obama appointed Dr. Donald Berwick
to be the director of the Centers for Medicare and Medicaid services. He had been honored
by Queen Elizabeth II for his work with the healthcare system in England—the system that
let that woman die. Dr. Berwick spoke frequently of his admiration for that system. He said
quote “The chronically ill and those toward the end of their lives are accounting for potentially
80% of the total health care bill out there. The decision is not whether we will ration care.
The decision is whether we will ration with our eyes open." "There needs to be global budget
caps on total healthcare spending for designated populations." Unquote. Designated
populations. That just may mean YOU. The Democrats claim that healthcare is a right—but
a right for whom? I guess they get to decide, not us. Whatever happened to government for
the people?? Obama and the Democrats have created a government over the people. This
healthcare law, Obamacare, could mean the end of America as we know it.

(Note: This commentary is by Dr. Jill Vecchio.)