Wednesday, August 12, 2009

Uncle QALY

Yesterday, Barack Obama, at a Town Hall Meeting, laughed-off the "rumor" that Obama-Care will pull the plug on "Grandma" when the Federal government decides that it is the time to end her life. Many point to the section of HR3200 (the primary House version of the Health Care Reform Bill) that mandates that patients, who are age 65 and beyond, receive end-of-life counseling as proof of this. However and in reality, there is no such actual "euthanasia" language in the entire bill.

What is in the bill is the creation of a Health Choices Administrator (Commissioner) as defined in the "governance" subsection of Title I of the bill. On a cursory basis, this new agency, that reports directly to the President, looks to be a regulatory agency of the Federal government who will oversee the health insurance industry. But the Administrator's responsibilities are very broad because there is "no" limiting language. In fact, there seems to be absolutely no limits placed on this agency in dealing with the insurance companies. Simply speaking, this new agency will "decide" what medical practices and procedures will be allowed under any insurance company's offered coverage. Any, and all, decisions by this agency are then legally binding under Federal Law. Insurance companies who either violate the mandates or who are even thought to have violated the dictates of this agency will be subject to audits, fines and, in, worst case, an ordered liquidation of that company. If an audit is ordered against a company, for any reason, that company will be forced to pay the cost of the audit; even if it is found to be in full compliance.

This is where the dirty work of the "end of life" decisions will be made. Don't expect euthanasia to be clearly outlined or specified by this agency. What will happen is that it will mandate rules regarding the extent of care that anyone can receive depending on their age, their sex, and their relative and pertinent health conditions and, even, their value to society.

In the U.K., the national health system's medical practice and procedures rules are dictated by an agency that carries the cute and non-threatening acronym: NICE (Click to See Full Story). However, if you are disabled or aged and you need expensive health care, NICE may not be so nice. That's because NICE guidelines are based on the principles of QALY or Quality-adjusted life year (Click to See Full Story). In effect QALY analysis will determine whether or not care is given or withheld; based on age and other factors that can include a patient's value to society. In other words, if you are a 78 year old male who is, in QALY's viewpoint, 3 years past your life expectancy, QALY might deny you a heart transplant or some other heroic effort to extend your life because the cost of do so is too high; relative to the likelihood of you "possibly" dying soon. At the same time, heroic efforts might be denied to any mentally-challenged or severely disabled children or babies because their quality of life or life expectancy is considered to be too limited.

In a way, QALY is a backdoor form of euthanasia because it doesn't actually pull the plug on your life. Instead, it just denies you the treatments you may need to keep you alive. That is the real intent of the Health Choices Administration as defined by HR3200. And, that's where "Grandma" will lose her life. Uncle Sam's QALY guidelines will effectively overrule any desires by the doctor, or a family or the patient for any lifesaving procedures. That's where the Democrat's plan will ultimately save money. This is because the bulk of the costs for anyone's health care generally comes in the last few years of their life.

Uncle QALY is the true Grim Reaper in this health care reform bill. And, to that extent, Obama was really stretching the truth when he said the Federal Government won't pull the plug on Grandma. He knows damn well that, after implementation, a bureaucrat, running the Health Choices Administration, will determine Grandma's fate. The pure goal of that agency is restrict what it determines to be unnecessary. Anyway you shake it, that is rationing and that is medical care being denied. To say otherwise is pure lie!

By The Way... QALY practices are why the Insurance Companies are backing Obama-Care. Their massive insurance payouts will be reduced by the government-mandated restriction on health care procedures and care. For them, Uncle QALY, not them, will now become the bad guy who is denying your care.

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