IT'S ALL A DEATH PANEL: THE TRUTH ABOUT OBAMACARE

By DICK MORRIS & EILEEN MCGANN

Published in the New York Post on August 17, 2009

Washington is all atwitter about "death panels": President Obama derides
the idea that his health-care reform calls for them; the Senate is
stripping "end of life" counseling language from its bill -- and last
Friday the voice of the liberal establishment, The New York Times, ran a
Page One story "rebutting" the rumor that ObamaCare would create such
boards to decide when to pull the plug on elderly patients.

But all those protests miss the fundamental truth of the "death panel"
charge.

Even without a federal board voting on whom to kill, ObamaCare will
ration care extensively, leading to the same result. This follows
inevitably from central features of the president's plan.

Specifically, his decisions to (1) pay for reform with vast cuts in the
Medicare budget and (2) grant insurance coverage to 50 million new
people, vastly boosting demand without increasing the supply of doctors,
nurses or other care providers.

Whether or not he admits it even to himself, Obama's talk of cutting
"inefficiencies" and reducing costs translates to less care, of lower
quality, for the elderly. Every existing national health system finds
ways to deny state-of-the-art medications and necessary surgical
procedures to countless patients, and ObamaCare has the nascent
mechanisms to do the same. With the limited options that Obama's vision
would leave them, many will find that "end of life counseling" necessary
and even welcome.

"Reform" would cut care to the elderly in several ways:

* Slash hundreds of billions from Medicare spending, largely by lowering
reimbursement rates to doctors and hospitals for patient care.

If a hospital gets less money for each MRI, it will do fewer of them. If
a surgeon gets paid less for a heart bypass on a Medicare patient, he'll
perform them more rarely. These facts of the marketplace are not only
inevitable consequences of Obama's cuts but are also its intended
consequence. Without them, his savings will prove illusory.

* Expanding the patient load by extending full coverage to 50 million
Americans (including such "Americans" as illegal immigrants) without
boosting the supply of care will force rationing decisions on harried
and overworked doctors and hospitals.

People with insurance use a lot more health-care resources -- so today's
facilities and personnel will have to cope with the increased workload.
Busy surgeons will have to decide who would benefit most from their
treatment -- de facto rationing. The elderly will, inevitably, be the
losers.

* The Federal Health Board, established by this legislation, will be
charged with collecting data on various forms of treatment for different
conditions to assess which are the most effective and efficient. While
the bills don't force providers to obey the board's "guidance," its
recommendations will still wind up setting the standards and protocols
for care systemwide.

We've already seen Medicare and Medicaid lead a similar race to the
bottom with their formularies and other regulations. With Washington
dictating what every policy must cover and regulating all rates,
insurers and providers will all have to follow the FHB's advice on
limiting care to the elderly -- a de facto rationing system.

* In assessing whether to allow certain treatments to a given patient,
medical professionals will be encouraged to apply the Quality-Adjusted
Remaining Years system. Under QARY, decision-makers seek to "amortize"
the cost of treatment over the remaining "quality years of life" likely
for that patient.

Imagine a hip replacement costing $100,000 and the 75-year-old who needs
it, a diabetic with a heart condition deemed to have just three
"quality" years left. That works out to $33,333 a year -- too steep!
Surgery disallowed! (Unless of course, the patient has political
connections . . . )

Younger, healthier patients would still get the surgery, of course. The
QARY system simply aims to deny health care to the oldest and most
infirm, "scientifically" condemning them to infirmity, pain and earlier
death than would otherwise be their fate.

In short, ObamaCare doesn't need to set up "death panels" to make retail
decisions about ending the lives of individual patients. The whole
"reform" scheme is one giant death panel in its own right.