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August 10, 2013

Oregon Denies Chemotherapy To Medicaid Patients With Less Than Two Years To Live

Via Brian Faughnan....Paging Sarah "Death Panel" Palin. Sarah "Death Panel" Palin to the White Courtesy phone.

Like most such panels, including the Affordable Care Act’s Independent Payment Advisory Board, the Oregon Health Evidence Review Commission, or HERC, claims to be merely concerned with what supposedly works and what doesn’t. Their real targets are usually advanced, costly treatments. That’s why HERC, for example, proposed in May that Medicaid should not cover “treatment with intent to prolong survival” for cancer patients who likely have fewer than two years left to live. HERC presents an example to show their reasoning for such a decision: “In no instance can it be justified to spend $100,000 in public resources to increase an individual’s expected survival by three months when hundreds of thousands of Oregonians are without any form of health insurance.”

Here's a dirty little secret...I get the politics of why ObamaCare opponents latched on to "Death Panels" but when it comes to Medicaid and Medicare, if you want to restrain costs, rationing is pretty much the only way you can do it. You can talk about efficiency and best practices all you want but the reality is the only way to actually get control of the cost of these programs is to cap the amount you're willing to allocate to them and divide the money up among recipients as best you can. At some point that's going to require cost/benefit analysis on the services provided to people. The biggest driver of costs for Medicare is end of life care.

The cost of end-of-life care is particularly problematic for Medicare. Most people who die in America, no surprise, are elderly Medicare beneficiaries and the program is grappling with its long-term financial viability. Care at the end of life is far more expensive for Medicare than spending on a typical beneficiary. The Centers for Medicare & Medicaid Services estimate that more than 25 percent of Medicare spending goes towards the five percent of beneficiaries who die each year.

This results in spending for decedents (persons who are in their last year of life) that is six times greater than the cost for a survivor. For example, in 2006 Medicare spent an average of $38,975 per decedent compared to $5,993 for other beneficiaries (survivors), health care researchers Gerald Riley, of the CMS, and James Lubitz, of the Urban Institute, found.

It's ugly but it's math.

To me the problem with ObamaCare is that it ropes almost everyone into this sort of government cost/benefit calculation. Until now, if you wanted a plan that would pay for everything until the minute you died, fine. You paid the premium, you get to pick the product and level of care you want. ObamaCare does away with that by placing exorbitant taxes on those types of plans and by setting up a series of incentives for companies to stop providing insurance to workers and forcing them into the government run exchanges, which then limits your options and subjects you to the government's need to control costs.

Yes, there was an inequality between people who had private insurance and those who relied on government plans. But that's just life. If you provide insurance for yourself, you are free to value how much you will pay for it against the amount of services you will expect in return. That's between you, your insurance company and your health care providers. If you rely on society to provide that to you, you will not have as much control over how much you receive from others. If you rely on others to pay for you, human nature being what it is, most people will decide to spend more of their resources on themselves than on people they don't know.

And spare me the, "I paid for Medicare all my life! It's mine!". It's not true.

That's the true aim of ObamaCare...to remove that "inequity" (unless you're a member of Congress or one of the other privileged classes in our brave new world). Now you selfish bastards can no longer spend your own money on yourself as you see fit. You will be forced to pool your resources so that we all may be equal. Naturally, "equal" will be defined by the experts in DC, who won't be subject to their own brand of "fairness".

Oh, Harry Reid says ObamaCare is just the first step to single payer.

But trying to defund/repeal ObamaCare isn't the hill to fight on or something.


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posted by DrewM. at 11:07 AM

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