I have a piece in today’s NRO about the Liverpool Care Pathway, which we have discussed here previously at SHS. From my column:
The United Kingdom continues to provide vivid warnings about the dangers of centralized health-care planning — a real possibility under Obamacare. Within the last few years, the U.K.’s notorious rationing board, the National Institute for Health and Clinical Excellence (NICE), urged hospitals, nursing homes, and hospices to follow an end-of-life protocol known as the Liverpool Care Pathway. The Pathway’s guidelines instruct doctors to put patients thought to be near death into a drug-induced coma, after which all food and fluids, as well as medical treatments such as antibiotics, are withdrawn until death.
The problem with such a protocol is that no matter how well motivated — and undoubtedly, the Pathway’s creators had good intentions — follow-the-dots medical protocols often lead to patients’ being treated as members of a category rather than as individuals. At that point, nuance often goes out the door, and mistakes, neglect, and even oppression frequently follow.
I get into some of the horror stories, such as the man put into a coma and dehydrated who turned out not to have cancer. And then I tie the Pathway into Obamacare:
This is precisely the paint-by-the-numbers medical approach that Obamacare threatens to bring across the pond to our shores. Indeed, former senator Tom Daschle — whom the New York Times called the most influential adviser to the president in the health-care debate — has long urged that America adopt NICE-style centralized medical planning. Indeed, according to Scott Gottlieb, writing in the Wall Street Journal, Daschle “argues that the only way to reduce spending is by allocating medical products based on ‘cost effectiveness.’ He’s also called for a ‘federal health board’ modeled on the Federal Reserve to rate medical products and create central controls on access.”
Chillingly, current Obamacare plans call for the creation of many cost/benefit/best-practices boards, the full power of which won’t be fully known until the bureaucrats promulgate tens of thousands of pages of regulations between now and 2013, when the law would go into effect. Making matters more alarming, these boards would not only govern treatment provided in any public-option health plan, but would also be empowered to set the standards of care paid for by private insurance. Unless the final version of Obamacare is amended explicitly to prohibit such centralized health planning, don’t be surprised if an American version of the Liverpool Care Pathway comes soon to a hospital or nursing home near you.
Obamacare is intent on cutting costs. The great danger is that while the government will never ration its own spending, never cut its own perks, never decide that a program has outlived its usefulness, it will readily cut the most vulnerable among us out of life itself.
