While catching up on the latest posts and comments on FA this morning, a Bloomberg article by Betsy McCaughey that Missy provided on another thread caught my eye.
Per Ms. McCaughey, there is a dearth of objections by either side of the aisle to some health provisions slipped into the House stimulus bill. Apparently, there is to be a government body monitoring doctors “to make sure your doctor is doing what the federal government deems appropriate and cost effective.” Also included are some new penalties for doctors and hospitals that aren’t “meaningful users” of the new system.
Okay… We’ve all heard Obama campaign on digitizing medical records to increase efficiency and cut costs. This, in itself, isn’t a bad thing (unless abused, of course… as it apparently is planning on being with the House stimulus). But before we get in an uproar, over something, let’s get some background.
According to a CNS news article by Susan Jones today, she states much the same as Ms. McCaughey, but with a twist:
One provision creates a National Coordinator of Health Information Technology, “designed to monitor your treatments, to make sure your doctor is doing what the federal government deems appropriate and cost effective,” as a commentary on the Bloomberg news wire reported on Monday.
Wrong…. According to the Health and Human Services Department’s website, the position of the National Coordinator for Health Information Technology, contained within HHS, was created by an Executive Order by George W. Bush in 2004. It’s goal was to
The primary purpose of this position is to aid the Secretary of HHS in achieving the President’s Goal for most Americans to have access to an interoperable electronic medical record by 2014.
Mata Musing: See their Summary of Strategic Framework for details.
So Obama’s quest for digitizing medical records is neither original, and this department is not a new creation.
But Ms. McCaughey straightens out some misinformation on what is new to the ONC (Office of the Nat’l Coordinator).
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.
The Heritage Foundation’s Helen Evans did an analysis on this Council for Comparative Effectiveness back on Feb 4th after the bill passed. Included is a fascinating history on the roots of such research back to mid 18th Century Scotland. Even more interesting is the introduction to the European comparative effectiveness agencies providing similar functions.
I’ll let you go thru this extensive overview yourselves, and quote from her final analyses.
During the presidential campaign, Barack Obama proposed an Institute for Comparative Effectiveness that would make formal recommendations on medical technologies, devices, and drugs. In Congress, champions of comprehensive overhaul of U.S. health care favor policies that would explicitly accelerate America’s trajectory downward toward a European-style medical interventionism.
Fearing the impact of the rising costs of Medicare, Medicaid, and the highly regulated arrangements of the private insurance sector, many American legislators and other top policymakers are becoming attracted to the idea of a body that would make top-down pronouncements on the cost-effectiveness of new medical technologies. The idea of a statutorily created agency charged with system-wide cost containment and rationing of medical services and technologies is becoming surprisingly fashionable in Washington policy circles.
The implications of this trend are alarming for U.S. citizens, particularly when one considers that the technology a society uses reflects the wider and underlying incentive structures it adopts for using it: “An incentive structure that encourages providers to trade off the costs and benefits of health care gives providers little incentive to use expensive technologies and thus researchers will have little incentive to create it.”[33]
In the long term, a statist, centralized control of medical technology offers little if any regulatory benefit. Through its own logic, it not only stifles innovation, but also, in doing so, ends up precluding those very inventions that could turn out to be of immeasurable benefit to individuals and to society in general.
Again, another link from Missy with American Thinker’s Doug O’Brien today about what seems to be the intents of this government oversight “comparative effectiveness” advisory council.
The Canadian Free Press’ Sher Zieve suggests the bill, as written, could be used to “eliminate” senior citizens by withholding lifesaving measures.
In this post, I’m not here to battle the pros and cons specifically on incorporating more of the decision making under state control here… i.e. centralizing government control of patient access to drugs, devices, medical technologies, treatments, or procedures; or the emphasis on cost containment vs quality and value of treatments. Frankly, I haven’t finished reading the House bill on this specific provision to be armed with anything but pundit commentary thus far.
Instead, if you’ve read this far, it appears you are already more informed than your elected official in Congress.
Yes, folks… back to that CNS News article I mentioned above. When Fox News mentioned the Bloomberg’s article, pointing out this creation of the comparative effectiveness government creation, he was dumbfounded…
Specter told Fox News, “If Bloomberg has pointed out a potential problem…there will be clarification to avoid having the government meddle in what doctors do.”
~~~Specter said the provision was intended to “provide technology” – to computerize the health records of all Americans. He said the government should not be in the business of making decisions on patients’ treatment.
~~~“This is one of a number of provisions that has popped up that we have to revise and be very careful about,” he said.
Specter said he has protested the rush to judgment, but “the only answer we get is that the situation is so dire, such an emergency, we have to act.” Specter, asked if he would now put a stop to the bill or at least slow it down, indicated that he would not.
“Listen, this legislation is a bitter pill to swallow. But we are facing a situation where the current economic problems could turn into another depression like 1929.” He said he would not change his “yes” vote.
“We will get this provision clarified. I’ve made a commitment, and I’m not going to go back on my word and on a commitment. But when we find problems of this potential, we can cure them without upsetting the whole apple cart.”
The almost-a-Republican was not the only one who was apparently unaware of this provision in the bill.
Sen. Jon Tester (D-Mont.) told Fox News that the stimulus bill is about jobs. “If – that’s a big if – if there’s language in there that says the government’s going to make my health care decisions, we’ll get it out. I don’t believe that,” he said.
“I think that the consumer is pretty well protected. I think what this is meant to do is move us into the 21st Century for health care records,” Tester continued.
“If it’s in there, it’s a bad idea. But the fact is if that can be fixed, it will be fixed, if it’s in there, it will be changed and made better and made workable – and then, the bottom line is, to put people back to work.”
“If it’s in there…”????
We had this same problem when this same group of representatives of “the people” didn’t bother to read the original Paulson bailout, then got on the talking head circuit expressing their utter surprise and indignation when they found out they didn’t know where the money went until later, and most especially were not going to know how the TARP money recipients were going to use the cash.
Well, duh… that’s because that’s the way they themselves wrote the legislation.
I used to believe this outrage then demonstrated was but a partisan joke to absolve their irresponsible butts of blame. But after finding out they are clueless to this bill as well, perhaps I was misjudging them. Fact is, they may honestly have been in the dark.
Why? Because it’s quite obvious that Congressional members prefer to vote without reading and understanding just what they are voting for. And frankly, spending our money, that should be a crime of willful negligence.
Vietnam era Navy wife, indy/conservative, and an official California escapee now residing as a red speck in the sea of Oregon blue.
Specter is up for reelection in 2010. Time to find a better candidate to unseat him. I sent him an email expressing my opinions already.
It is sort of funny how these guys will waffle and say ‘well, if it’s in there, … it will be fixed’, as if this was an excuse for letting bad bills become law. Sort of like what happened with the CPSIA, when Congress passed a bill that banned selling any children’s toys, books or clothes that hadn’t been tested/certified lead free. Well intended perhaps, but so sloppily written that it would have made selling these things at yard sales, flea markets or thrift stores illegal. Of course, in response to the uproar, the bureaucrats in charge offered up some guidelines for enforcement, which are saner than the bill as written. But since when is some agency supposed to be revising the law? They should enforce it until Congress changes it, which I hope would be soon. (No points for guessing which Congressman opposed the bill).
Interesting stat: the average size of the bills passed by Congress in 1947-48 was something like 2.5 pages. The ‘stimulus’ bill was over 600 pages. Even so, given it’s importance, you would think the Senators could have read it in the few days available to them.
another step closer to ruining our health care. wonder what all of the nice old folks who voted for him are thinking now,bet they are not happy. what will this do to private insurance?
McCain had the same problem with the energy bill which mandates the end of the incandescent light bulb. He insisted that the ban wasn’t in the bill. Clearly, he had not read the entire bill and that is so in this case too.
This “emergency” jobs bill is loaded with little goodies like the one above. That’s why the Dems were in such a rush to pass it.
Healthcare records for ALL Americans – including those living on Indian Reservations and those in the wilds of Alaska – have been computerized since the 90’s, the early 90’s. As a matter of fact, the American Taxpayer has already PAID for that once, via a grant to the programmer who developed the software most commonly in use. (The program was his doctoral thesis.)
That may not be a good idea. If he losses in a primary there’s no guarantee who ever beats him will be able to win his seat in the general. After the last election, I don’t think PA will be an easy state for a nonincumbant Republican to win.
@Fit fit:
For what value he has to the Republican Party, the people of PA may as well give us a Dimmy.
If he losses in a primary there’s no guarantee who ever beats him will be able to win his seat in the general.
If I’m going to involve myself in politics at all, then: I believe that it’s not my mission to accept crappy candidates just because other people support them, it’s my mission to get *other people* to accept candidates they might not agree with 100%, because I think they’re great.
Now of course better still is if I can change people’s minds about what makes a good candidate. But I think if you’re going to set out from the very beginning with a view towards compromising on some guy just because he’s the incumbent, you might as well stay home until election day.
Granny #4. The fact that personal records may be residing on a computer in your doctor’s office or hospital facility somewhere is not the same thing.
This is about a Nationwide Health Information Network (NHIN) with interchangable data standards and formats connecting providers, consumers, and others involved in supporting health and healthcare. That does not yet exist.
Any software program developed for the 90s is outdated with today’s technology, and is unlikely to provide the foundation for a nationwide network.
>>After the last election, I don’t think PA will be an easy state for a nonincumbant Republican to win.>>
Tough. Likewise Collins and Snow.
Better the Devil you know than the Devil you _don’t_ know.
If they’re not _Republicans_ as clearly demonstrated by their votes, then they shouldn’t falsely represent that they’re voting the way the Republican voters want them to vote. If the Republican voters don’t like how they vote, they should lose.
My dear Fitty,
Now don’t get youself in a tizzy if the “Specter” gets exercised. Not much of a diff if he gets replaced with a demmie.
I think Bonnie Newman will be joining in with Collins and Snowe on several votes. She described herself as a “reasonable Republican” and then as a “moderate Republican”. To me that implies she’s saying conservative Republicans aren’t reasonable.
Then again, there’s a lot of both sides of the aisle that think we’ve been sold a pile of manure, Fit.
So, since I know you’re a moderate whatever yourself, just what do you say is “unreasonable”? Opposition to the bill is “unreasonable?
And here I thought it was very American…..
As I said before, I think Republicans should have pushed a single idea: Corporate tax cuts as their ultimatium/compromise. Instead, they whined and stamped their feet and in the end only confirmed their impotence.
Other than stating their opposition (aka “whining”), just what do you think they can do, Fit?
Fact is, there is nothing that the GOP can do other than make a formal statement that may (or may not) meet your approval. With all the House “gone”, and only Snowe, Collins, Specter as the last bastions of conservative (and I use that laughingly…) as Senate defense, who the F#(k cares *what* they say in opposition? It’s a moot point.
The fact they register *any* defense is enuf.
One thing that concerns me greatly about a Nationwide Health Information Network (NHIN) is that the government will have access to your records. So much for patient – Doctor confidentiality. And you can bet that employers will also want Congress to grant access to your records, just as they do now with running credit-checks on employees (A practice that I personally think should be none of your employer’s business). Then your land lord or mortgage company will want a look, then the police will want to be able to access it for when they pull you over, etc…
Ask yourself, where will it ever end? What about the Fourth Amendment?
Thanks Mata, lot of information to absorb. If the healthcare portion of the Stimulus was something to be proud of it would be bragged about in every speech on Obama’s tour. It would be something he could use to sell this turkey, but so far, no mention of it whatsoever. I believe, if confronted with this issue, he would lie, just like he did about BAIPA, half the country would believe him.
I’ve worked very hard with my disease trying to prolong the inevitable. My doctor advised me to make those bones work and stay off ladders, a fall could be fatal. Still shoveling snow, slowly and mowing, slowly. Matter of fact, I look forward to it, helps me think I’m winning. I can lift my 24 pound grandson, but can’t pick my 17 pound dog up unless he gets up on the couch. Just have to know how to use my body and I get by.
What worries me is if something should happen to my husband, I might have to someday depend on the government as others now do. What sickens about this hidden agenda is how easy it is for the power mongers to deny the infirm elderly support not caring about how eliminating their care affects them. Denying them the new drugs that will stifle research, as explained in your post above.
BTW, from the links you provided, this also includes the VA, military and all other government funded healthcare. DC recipients should be on the steps of Congress with picks and axes right now, if they only knew.
ditto, this is a link from one of the sources Mata provided.
http://www.os.dhhs.gov/healthit/framework.html#report
I see this initiative as a good thing, it’s government helping to get the private medical industry online to advance our care, not ration our care and privacy is built into it.
From a couple of personal experiences, I have learned how protected our information is, as of now anyway.
Comment in spam. P&T
Having watched democrats dodge this issue while being questioned yesterday, using the “move along, nothing to see here” approach, Congressman John Shadegg comes clean. After watching his interview I checked his site and found this:
“Comparative Effectiveness Research,” sounds innocuous, but big-government programs always do. The $1.1 billion of the stimulus package earmarked for this project is a significant step toward government-run healthcare. Comparative effectiveness research is a tool for bureaucrats to decide which medical treatments Americans should or should not have access to.
In countries with government-run healthcare systems, comparative effectiveness is often used as an excuse to deny patients life-saving medical care on the grounds of cost-effectiveness. The healthcare board of the United Kingdom has repeatedly denied breakthrough drugs to citizens suffering with breast cancer, Alzheimer’s, and even multiple sclerosis on the grounds of comparative effectiveness. The British government has stripped citizens of the freedom to choose their own healthcare. Congressman David Obey, chairman of the House Appropriations Committee, has already admitted as much. Just read his own words from the committee report on the stimulus, talking about this provision: “Those items, procedures, and interventions… that are found to be less effective and in some cases, more expensive, will no longer be prescribed.” We must not allow it.”
It’s in the stimulus package, they know it, admit it in committee, but deny it in public.