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Weekly Column: Stop Rationing Before it Starts


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Since the President is not going to sign a bill repealing his health-care law any time soon, those of us who oppose the law are trying to blunt the measure's impact.

The Senate, for example, has voted to repeal the so-called 1099 requirement, which requires businesses to report every purchase of $600 or more to the Internal Revenue Service (ostensibly to raise $17 billion). And, in order to prevent rationing of care, Senators Coburn, Barrasso, Roberts, Crapo and I introduced the Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act, a pro-patient firewall that protects patients' access to high-quality care by prohibiting the federal government from using comparative effectiveness research (CER) to delay or deny care.

CER weighs the effectiveness of two or more health-care services or treatments. It can provide patients and doctors with better information regarding the risks and benefits of a drug versus a surgery, for example; but in the hands of government it also could be used to determine if a certain treatment is an effective use of government resources.

Section 6301 of the health-care law actually empowers the Secretary of Health and Human Services to use CER when making coverage determinations.

Moreover, Donald Berwick, whom President Obama installed as administrator of the Centers for Medicare and Medicaid Services--the agency that will be implementing much of ObamaCare--supports rationing of health care. The decision is not whether or not we will ration care -- "the decision is whether we will ration with our eyes open," he said in a 2009 interview.

The Obama administration, insists that it will not ration care, but it is unavoidable in a government-run health-care system. In Britain, for example, the National Institute for Health and Clinical Excellence (NICE) routinely uses CER to make cost-benefit calculations.

In August 2008, NICE recommended against coverage of four expensive drugs for advanced kidney cancer. NICE considered the drugs clinically beneficial in specific situations, but concluded that they were not cost-effective. Health care in Britain is also routinely delayed. Several years ago, the country's National Health Service (NHS) launched an "end waiting, change lives campaign." The campaign's goal was to reduce patients' wait time to 18 weeks from referral to treatment--that's 4 1/2 months! And that's an improvement.

Government-run healthcare systems that ration care are the reason that many Europeans and Canadians come to the United States each year to get the treatments denied to them in their own countries. In some case, treatments are simply forbidden; in others, the delays in getting appointments result in denial of timely care.

Access to the highest quality care and the sacred doctor-patient relationship are the cornerstones of U.S. health care--the very things Americans value most and that ObamaCare jeopardizes. All Americans deserve personalized treatment and should be able to get the care that they and their doctors decide is best. No Washington bureaucrat should interfere with that right by substituting the government's judgment for that of a physician.

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