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Monday, March 2, 2009

Shut Up and Take Your Medicine

The O.G.M. (Office of Government Meddling) seems to think they know more about how to treat us than our doctors do. It's bad enough that Washington wants to take all our money and spend it for us, now they want to control health care as well.

If you have never heard of the National Coordinator of Health Information Technology, you need to take notice.

According to the HHS.gov site, the NCIH performs the following tasks.

Health information technology (Health IT) allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will:
Improve health care quality;
Prevent medical errors;
Reduce health care costs;
Increase administrative efficiencies;
Decrease paperwork; and
Expand access to affordable care.


Interoperable health IT will improve individual patient care, but it will also bring many public health benefits including:

Early detection of infectious disease outbreaks around the country;
Improved tracking of chronic disease management; and
Evaluation of health care based on value enabled by the collection of de-identified price and quality information that can be compared.

All sounds well and good.

But now look at what Betsy McCaughey opines at Bloomberg.com.

The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.
Even this sounds benign, but it get's worse.

Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time” (511, 518, 540-541)

What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.

The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.
Even though Mr. Daschle is not the HHS head, does not mean his fingerprints will not be all over any health care initiative coming from Washington. Kind of makes you wonder why the Prez is so adamant about EHR/EMR.

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.
This almost has a Star Chamber quality to it.

Of course there is a positive to all this. If you want to control health care spending, the easiest way is to deny coverage for treatment. Rationing always works.

AIG: Chutzpah Redefined

Honestly, I had decided not to post yet another diatribe on the travails of disgraced (former) insurance giant AIG. After all, there's an ethical Rubicon that I feared to cross, given that we'd beaten up on the carrier so often of late.
This morning brought news that they were back at the trough, demanding that we taxpayers fork over another $30 Billion.
But that was then, this is now:
And guess who pays for that bit of litigation?
Thee and me.
Please remind me again why we threw them a safety net?

Told Ya So...

COBRA/Spendulus: Another Update

[Welcome Industry Radar readers!]
Just got another email from our FSA/HRA/HSA Guru, who clarifies that:
"FSAs were specifically excluded from the temporary COBRA subsidy program. There are a couple of links below that speak to the subsidy and note the exclusion of FSAs."
He also sent along this helpful link.
Thanks, Pete!

Carnival of Personal Finance now online

Free Money Finance once again hosts the venerable collection of all thing financial. There's a LOT of material, and you're sure to find something useful.

Sunday, March 1, 2009

Much Ado About...Well?

Of all the "hot button issues" extant, perhaps none is more volatile than abortion. We take no official stand on this issue at IB (although I presume that each of us has our own opinion)(or maybe more than one), but this "theory" seems to be making the radar:
In brief, existing laws grant an exemption of sorts to health care providers who have moral reservations regarding abortion, allowing them to turn away patients who seek them. And I'd add that, although the linked article doesn't mention it, one would presume that pharmacists who refuse to dispense the so-called "abortion drug" (RU-486) would also fall under this proposal.
This seems to me to be rather more complex than it would at first seem: on the one hand, folks (currently) have the right to seek an abortion; on the other, providers shouldn't be forced to perform procedures (or dispense meds) with which they have moral and/or ethical problems. And, of course, there are few, if any, insurance plans that would cover either abortion or RU-486; perhaps those will become mandated benefits under the proposed new regulations.
Frankly, I'm skeptical that we'll see a wave of hospital closures as a result; it's not as if the rules require that providers perform the procedure. In fact, this isn't really a new set of laws, per se, but a rescission of a "rule that currently protects civil rights and the exercise of conscience in healthcare." If the rule is rescinded, then it seems to me that this will become a matter for the courts to decide. Whether that's good or bad remains to be seen.
David Stevens, CEO of the Christian Medical Association, avers that "(t)he real threat to healthcare access is driving out every healthcare professional who conscientiously practices medicine according to life-affirming ethical standards." While I personally object to the rule's rescission, I also think that statements like this do more harm than good, in that they seem to vastly overstate the case, thereby reducing their own credibility.
What do our readers think?

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