Death panels...coming to your town

iVillage Member
Registered: 07-07-2010
Death panels...coming to your town
Thu, 07-08-2010 - 5:31pm

Obama's Nominee to Run Medicare: 'The Decision is Not Whether or Not We Will Ration Care--The Decision is Whether We Will Ration Care With Our Eyes Open'

( – President Barack Obama’s nominee to head the Centers for Medicare and Medicaid Services, which runs Medicare, is a strong supporter of the government-run health care system in Britain, who said in a 2009 interview about Comparative Effectiveness Research: “The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open.”

The $787-billion stimulus law signed by President Obama created a Federal Coordinating Coucil for Comparative Effectivieness research in health care that some critics argue was a step toward rationing of heatlh care in the United States.

Donald Berwick, a professor of pediatrics at Harvard Medical School and the head of the non-profit Institute for Healthcare Improvement, was nominated by Obama on April 19, 2010.

In choosing Berwick, the Obama administration is implicitly admitting that the health care law passed by the Democrats in March will lead to the rationing of health care, said Sen. Pat Roberts (R-Kan.) in a May 19 press release.

Concerning Berwick’s 2009 comment about the rationing of health care, the White House released a statement to several news organizations in which spokesman Reid Cherlin said the following:

“No one is surprised that Republicans plan to use this confirmation process to trot out the same arguments and scare tactics they hoped would block health insurance reform. The fact is, rationing is rampant in the system today, as insurers make arbitrary decisions about who can get the care they need. Don Berwick wants to see a system in which those decisions are transparent– and that the people who make them are held accountable.”

The White House statement, according to Roberts, seemed to acknowledge that the new health care law would simply ration care in a transparent way.

“This is really a fascinating response. Instead of flat out denials of government rationing we have excuses,” Roberts said on the Senate floor on May 19.

“And if you read between the lines you will notice that for the first time ever in this debate the Obama White House is admitting that their health care plan will ration health care,” the senator said.

Roberts made it clear that he does not accept health care rationing “transparent or otherwise.”

“I am opposed to rationing whether it is done by the government or by an insurance company,” said Roberts. “I am not defending any of the practices of insurance companies who have unjustly denied claims. But the Obama Administration’s response does nothing to address my concerns that our government will ration care. Instead, we finally have an admission from the White House that this is what they plan to do.”

In a June 2009 interview in Biotechnology Healthcare, Berwick was asked: "Critics of CER (Comparative Effectiveness Research) have said that it will lead to rationing of health care."

He answered: "We can make a sensible social decision and say, 'Well, at this point, to have access to a particular additional benefit is so expensive that our taxpayers have better use for those funds.' We make those decisio all the tim. The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open."

In the same interview, he also said, “The social budget is limited—we have a limited resource pool. It makes terribly good sense to at least know the price of an added benefit, and at some point we might say nationally, regionally, or locally that we wish we could afford it, but we can’t.”

Berwick also talked about his romantic view of Britain’s socialized health care system on page 213 of a report he wrote entitled, “A Transatlantic Review of the NHS at 60,” published on July 26, 2008.

“Cynics beware: I am romantic about the National Health Service; I love it,” Berwick wrote. “All I need to do to rediscover the romance is to look at health care in my own country.”

In the same article, he wrote, “The NHS is one of the astounding human endeavors of modern times. … It’s easier in the United States because we do not promise health care as a human right.”

He further wrote, “Any health care funding plan that is just, equitable, civilized, and humane must – must – redistribute wealth from the richer among us to the poorer and less fortunate.”

Roberts said he personally did not understand this romantic view of socialized medicine.

“With cancer survival rates for women 10 percentage points higher in the U.S. than in England, and over 20 points higher for men, why does he think that their government-run system is superior to our system?” said Roberts.

“Limited resources require decisions about who will have access to care and the extent of their coverage,” Berwick wrote in the Jan. 27, 1999 edition of Nursing Standard.

“The complexity and cost of healthcare delivery systems may set up a tension between what is good for the society as a whole and what is best for an individual patient,” Berwick wrote in an article entitled, “A Shared Statement of Ethical Principle.”

“Hence, those working in health care delivery may be faced with situations in which it seems that the best course is to manipulate the flawed system for the benefit of a specific patient or segment of the population, rather than to work to improve the delivery of care for all. Such manipulation produces more flaws, and the downward spiral continues.”


iVillage Member
Registered: 05-26-2009
Sun, 07-11-2010 - 8:51pm

<<What you do not know CAN hurt you. The government determines which services they will and will not cover. If the government will not cover a procedure, your Tricare doctor will not even discuss that treatment option with you.>>

And I could say to you:

What you do not know CAN hurt you. The


iVillage Member
Registered: 05-26-2009
Sun, 07-11-2010 - 9:25pm

<<Well, first of all, I'll make whatever claims I feel are relevant to the discussion...and if they are as topical and widely reported as "the sky is blue" then I'm afraid that you not knowing about them says a lot more about you, than not holding your hand and spoon-feeding them to you does about me.>>

I'll take that as a 'No, I cannot back up my claim that Obama/democrats want to give free health insurance to illegal immigrants.'

<<If "4 million" came up during your search, don't you think you'd know the source you were looking at at the time?>>

Nearly 4 million hits came up (3.79 million to be exact) when I did your recommended search for "democrat" and "comprehensive immigration reform". Since I was specifically looking for a source to back up your claim of free health insurance, I added "free health insurance for illegal immigrants" to the query in order to hopefully wittle down the number of hits. That took it down to 1.5 million. Now obviously I do not have the time to go through 1.5 million hits, but in the many, many pages I went through, there was no proof of Obama or democrats offering free health insurance to illegal immigrants. That seems odd since it's apparently as widely known as "the sky is blue". The fact of the matter is


iVillage Member
Registered: 05-26-2009
Sun, 07-11-2010 - 9:53pm

Trust me, I've done my reading and I am most definitely educated and informed.


iVillage Member
Registered: 11-27-2009
Sun, 07-11-2010 - 11:11pm

"I would assume you mean that it negatively impacts their care, yet why does Britain rank above the US in most health measurements?"

Which ones are you referring to?

iVillage Member
Registered: 11-27-2009
Sun, 07-11-2010 - 11:16pm

Based on some of your claims here, I can't agree. You may be informed on the material you have chosen to become informed on, but that doesn't mean it's been adequate.
What do you think about Emanuel's "Complete Lives System"?

Here's a pov on Berwick you might be interested in.

Copying the NHS is the last thing the US should do
The future health care in both countries must involve a mix of state and private provision, says Janet Daley.

By Janet Daley
Published: 9:00PM BST 10 Jul 2010

Bad idea: Barack Obama has appointed a man as head of the American public healthcare programmes who professes a passion for some of the most discredited features of our NHS
This week, the Coalition will offer an example of how coping with an economic crisis may serve a reforming purpose. Having to cut back the power and the expenditure of the state will provide a rationale for dismantling the monolithic, bureaucratic monster that the NHS has become. In his health White Paper, Andrew Lansley will apparently propose sweeping away the command-and-control structure in which clinical decisions are taken and hospital procedures commissioned by Primary Care Trust administrators, rather than by general practitioners who actually come face-to-face with people in need of medical help.

Fine. But if GPs are to inherit all the authority in this system, then it should be possible for patients to choose – and change – their family doctors easily and without recrimination. For, alas, Mr Lansley has decided to pass on the powers that he is confiscating from the abolished PCT mandarins exclusively to doctors rather than to patients. This is a real missed opportunity, but never mind: he is at least facing the right way, devolving decision-making down to levels where it can be done with more responsiveness and sensitivity to individual needs, rather than with the impersonal, blanket uniformity of a target-driven central authority.

Conservative MPs support tax relief on private health insurance, poll showsThe US government, meanwhile, is galloping doggedly in the opposite direction, bizarrely determined to occupy precisely the ideological ground which Britain is abandoning. Barack Obama has, indeed, appointed a man as head of the American public health care programmes who professes a passion (no other word will do) for some of the most discredited features of our NHS. Dr Donald Berwick is to head the Centers for Medicare and Medicaid Services, which effectively means that he will be in charge of Obamacare – the new universal health care system on which the President has staked his political credibility.

The appointment has created an extraordinary kerfuffle, partly because it was made under highly contentious circumstances – as a “recess” appointment which allowed it to bypass Congressional approval – but primarily on account of Dr Berwick’s widely disseminated statements extolling the virtues of the most disliked aspects of state-funded medical care as we know it.

Dr Berwick professes a love (which he describes in ecstatic terms that will have a tragicomic ring to most British ears) of just those evils of a national health system with which we are exasperated: the calculated rationing of treatment, and the ruthless enforcement of uniform cost limits, which often puts the most advanced medication and procedures out of reach of patients whose lives might have been extended or transformed by them. Dr Berwick thinks that our own dear National Institute for Clinical Excellence (Nice) – which is scarcely ever out of the headlines for denying some poor suffering victim a remedy that is available in other countries – is simply wonderful.

Unfortunately, Dr Berwick is quite right to draw these particular conclusions about the inevitable consequences of state-sponsored health care. Which brings us back to Mr Lansley and his not-really-all-that-radical reform of the NHS. At a time when both the demand for care and the scope of medical innovation are virtually infinite, a tax-funded health system must involve rationing and often the outright denial of advanced, cutting-edge treatments. There may be no theoretical limit to what miracles medical science can deliver, but there is certainly a limit to what taxpayers can subsidise, or to what governments can spend if they are not to starve every other public service to the point of death. The Government’s refusal to cut NHS funding – at whatever cost to other departments – is rightly condemned as wrong-headed and politically cowardly.

So why the inevitability of those aspects of our system which we most dislike? Why is Dr Berwick correct when he says that the NHS way of doing things is basically sensible, given the principles on which it rests? Because we have – and America is apparently about to embrace – an approach to health funding which is inherently self-limiting. Rationing is what happens when you do not have enough of something to go around. And health care that is paid for entirely by taxation creates shortages where they need not exist.

In Britain, we have maintained a perverse ideological insistence on the principle that it is better to have rationed, centrally controlled, uniformly dispensed health care even if it is poorer in every sense – in terms of resources, productivity, and medical outcomes – than that in which individuals routinely contribute to the cost of their own care. The ban on what is called co-payment, or top-ups, is intended to ensure that no NHS patient will have access to better – or more – treatment than anyone else simply because he is wealthier. We prefer a uniformly mediocre standard of care to an “unfair” one in which the better-off may get different service.

This dogmatic self-denying ordinance against the supplementing of NHS provision by patients able and willing to pay has meant that no thought has been given to the role such a mechanism could play in raising revenue for the NHS as a whole. In Britain, we would be inclined to agree with Dr Berwick’s view (hugely inflammatory in America) that a civilised, humane health care plan must “redistribute wealth” from the richer to the poorer and less fortunate.

But we have failed to notice that such redistribution is not just a feature of taxpayer funding. All insurance is based on the principle of redistribution: the more fortunate, who have paid their premiums but not made a claim, are helping to pay for the less fortunate, who needed help. Medical care top-ups paid for by individuals, or by insurance policies designed for “top-up only” provision, could provide an extra stream of revenue for the NHS, and thereby help to fund better care for those not affluent enough to pay anything extra themselves.

If the barriers between private and public funding are not broken down, a health system fit for the 21st century will be for ever out of our reach. At a time when the limits of state power have become so clear, it is delusional to try to maintain a state monopoly in health, with all its self-imposed limitations and disadvantages. The future lies with a combination of state provision and private contribution: that is a lesson that both Britain and the US – coming from polar opposite ends of the debate – need to accept. Abandoning hidebound dogma is now a matter of life and death.

iVillage Member
Registered: 07-07-2010
Sun, 07-11-2010 - 11:22pm

>>> So you would consider a system in which all doctors are employed by the government and hospitals are owned and ran by the government to be socialized. And a system in which the government only funds the system but the doctors and hospitals are private would also be considered socialized in your eyes. Correct?

Yes...and in the eyes of many others as the definition of socialized medicine I provided earlier.

>>> That means that iyo both Tricare and Medicare are socialized single payer systems, right?


iVillage Member
Registered: 05-26-2009
Sun, 07-11-2010 - 11:50pm

A slightly higher life expectancy. Lower infant mortality. Fewer deaths related to surgical/medical mishaps. Lower rate of death from cancer (all cancers combined). More hospital beds. I could go on but really, it's pretty trivial when you think about it. Based on most measurements, the US and Britain are pretty close. But Britain spends quite a bit less to achieve very similar results, if not better in some cases.


iVillage Member
Registered: 07-07-2010
Sun, 07-11-2010 - 11:55pm

>>> So if that's the case then insurance companies (who only exist in order to make a profit) are in control of your care, correct? Assuming of course that you have private insurance.

I don't submit to your allegation that insurance companies only exist to make a profit, but in the broadest sense, the insurance company does control my health care.


>>> I would assume you mean that it negatively impacts their care, yet why does Britain rank above the US in most health measurements?

You'd have to be more specific and also provide a context for that particular ranking.

More people in Britain die from cancer thanks to universal healthcare!

Among women with breast cancer, for example, there’s a 46 percent chance of dying from it in Britain, versus a 25 percent chance in the United States. “Britain has one of worst survival rates in the advanced world,” writes Bartholomew, “and America has the best.”

If you’re a man diagnosed with prostate cancer, you have a 57 percent chance of it killing you in Britain. In the United States, the chance of dying drops to 19 percent. Again, reports Bartholomew, “Britain is at the bottom of the class and America is at the top.”

10 Surprising Facts about American Health Care

Fact No. 1: Americans have better survival rates than Europeans for common cancers. Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom. Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway. The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Fact No. 2: Americans have lower cancer mortality rates than Canadians. Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.

Fact No. 3: Americans have better access to treatment for chronic diseases than patients in other developed countries. Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease. By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

Fact No. 4: Americans have better access to preventive cancer screening than Canadians. Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:

* Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
* Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
* More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
* Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).

Fact No. 5: Lower income Americans are in better health than comparable Canadians. Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent). Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."

Fact No. 6: Americans spend less time waiting for care than patients in Canada and the U.K. Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

Fact No. 7: People in countries with more government control of health care are highly dissatisfied and believe reform is needed. More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either "fundamental change" or "complete rebuilding."

Fact No. 8: Americans are more satisfied with the care they receive than Canadians. When asked about their own health care instead of the "health care system," more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).

Fact No. 9: Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K. Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade. The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain. The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.

Fact No. 10: Americans are responsible for the vast majority of all health care innovations. The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country. Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined. In only five of the past 34 years did a scientist living in America not win or share in the prize. Most important recent medical innovations were developed in the United States.

Conclusion. Despite serious challenges, such as escalating costs and the uninsured, the U.S. health care system compares favorably to those in other developed countries.

iVillage Member
Registered: 07-07-2010
Mon, 07-12-2010 - 12:24am

>>> I'll take that as a 'No, I cannot back up my claim that Obama/democrats want to give free health insurance to illegal immigrants.'

If it helps you sleep at night.


>>> Nearly 4 million hits came up (3.79 million to be exact) when I did your recommended search for "democrat" and "comprehensive immigration reform". Since I was specifically looking for a source to back up your claim of free health insurance, I added "free health insurance for illegal immigrants" to the query in order to hopefully wittle down the number of hits. That took it down to 1.5 million. Now obviously I do not have the time to go through 1.5 million hits, but in the many, many pages I went through, there was no proof of Obama or democrats offering free health insurance to illegal immigrants. That seems odd since it's apparently as widely known as "the sky is blue". The fact of the matter is your claim is not true.

Maybe your google is broken...I got it on the very first hit...

"President Obama said this week that his health care plan won't cover illegal immigrants, but argued that's all the more reason to legalize them and ensure they eventually do get coverage."

Asked by CBS News' Katie Couric in an exclusive interview whether illegal immigrants should be covered under a new health care plan, President Obama responded simply, "no." But he said there may need to be an exception to that policy for children.

"First of all, I'd like to create a situation where we're dealing with illegal immigration, so that we don't have illegal immigrants," he said. "And we've got legal residents or citizens who are eligible for the plan. And I want a comprehensive immigration plan that creates a pathway to achieve that."


>>> I'm not conceding anything. I never said anything about "go back to the end of the line".

No, Obama said "start over"...but both mean pretty much the same thing.

>>> I would assume that it would be possible though for there to be method in which someone can remain in this country and have to get in line, so to speak, in order to gain citizenship.

Yes, there is a's called amnesty.

>>> As for a "mass exodus", I don't think there would be one. As I already said, I don't think it would be possible to deport that many people.

Sure it would be...quite easily. Build a really big fence, and when you find and illegal, boot 'em back across the border.

>>> If conservatives got their way though and all 12 million people were deported, would that not be a "mass exodus"? It would indeed be the departure of a large number of people, would it not?

No, it wouldn't...unless all of the illegals came rushing forward to turn themselves in en masse, and that's not likely. A more realistic scenario is that the US would actually enforce it's immigration laws and that we would build the fence, increase border security and deport illegals as we find them.

>>> By the way, although there are certainly people who leech off of our country, illegals as well as some Americans, there are also millions who give something to this country. Not to mention off course, the millions of dollars they add to our economy.

Well, at least our leeches are American citizens, so they've got a leg up. It's the illegal leeches we need to get rid of...the ones who don't pay taxes, who use our resources and who take billions from our economy and send much of it back across the border to Mexico.


>>> That's not even worthy of an eyeroll.

Awww...c'mon...sure it is.

>>> I guess you don't know how to actually go about deporting 12 million people either.

Of course I's very simple. When you find an illegal you arrest them. Then you turn them over to ICE. Then you put them on a truck and drive them across the border. See how simple that was?


>>> Obviously you just want to be snide and aren't up to having a serious discussion. Now I see why it's mainly conservatives on this board. Take care.

I'd like to have a serious discussion but it would have to start with both folks who were informed on the issues. And it's mainly conservatives on this board because the liberals have largely gone silent because they don't have Bush around to attack and they can't defend their Obamessiah's gross failures and ineptitude.

Edited 7/12/2010 2:46 am ET by sylvanus.wood
iVillage Member
Registered: 05-26-2009
Mon, 07-12-2010 - 12:35am

<<Based on some of your claims here, I can't agree.>>

What claims would you be referring to?


I think it's realistic and the most ethical approach when dealing with scarce life-saving interventions such as organ transplants. Out of curiosity, do you believe it's wrong to limit initial batches of flu vaccines to the very young or the elderly? I would assume not because it just seems to make sense. Their immune systems are not as strong and they'd be more likely to suffer complications if they came down with the flu, right? But what about that person who may not have been able to receive a vaccination due to their age? If they died due to complications, would you still think it's ethical to give vaccinations to children and seniors first? I would.

As for the rest of your post, I think there are pros and cons