Washington (State) Rations with Its Eyes Open
Speaking at the AHIP convention in San Francisco yesterday, former Majority Leader Tom Daschle praised Obamacare’s board of unelected bureaucrats that will be empowered to make changes in Medicare policy: “I can’t think of anything…that is more important than ultimately giving some real authority to someone to make these tough decisions.” Sen. Daschle’s 2008 book Critical likewise praised the idea of having unaccountable bureaucrats make “tough decisions,” writing that “We won’t be able to make a significant dent in health-care spending without getting into the nitty-gritty of which treatments are the most clinically valuable and cost-effective.”
Washington – the state, not the city, that is – has given a board of bureaucrats the power to do just that, and its experience is illustrative of what all Americans can expect when Obamacare’s bureaucratic board finally convenes. The Seattle Times reports on the state’s board, which meets later this afternoon:
If you want trouble, try telling a mother that insurance will no longer pay for her diabetic teenager to test his blood-sugar levels as often as she thinks he should.
Or tell a man who was crushed in a workplace injury that he can’t have the spinal injections for pain control he says are the only thing keeping him going.
That’s the job of the state’s oft-vilified Health Technology Assessment committee, a group of 11 health professionals charged with deciding whether taxpayer dollars should be spent on certain types of medical care for injured workers, people on Medicaid and state employees.
In an effort that’s unique in the country in depth and scope, the committee decides — at open meetings — which procedures, treatments and tools are effective and cost-efficient, and thus worthy of state dollars.
Far more persuaded by empirical data than personal anecdotes, the committee has passed judgment on newer technology such as upright MRIs and virtual colonoscopy, and on the more familiar — such as cardiac stents, arthroscopic knee surgeries, hip resurfacing and breast MRIs.
And despite the Administration’s claims that Obamacare’s board will be pollinated by experts, the Seattle paper notes that the Washington state board’s members “are, by design, not experts in the technologies they review… as a consequence, they sometimes appear less-than-fully informed — critics would say clueless — about the technologies they are assessing.” The board members ARE however “experts in evaluating evidence” when it comes to the cost-effectiveness of treatments, meaning whether a particular course of action may be too expensive for the government to cover it.
To sum up: A board of “experts” – who may or may not actually BE “experts” – gather in a room and pass judgment on whether the government will cover procedures like colonoscopies, breast screenings, diabetes test strips, and cardiac stents. If you want a preview of the future under Obamacare – what Medicare Administrator Donald Berwick called “rationing with our eyes open” – you would be well advised to make a trip to the Pacific Northwest.