Obamacare’s Next Phase: Pay for Rationing?
The New Yorker’s Ryan Lizza is out with an extended feature article chronicling key moments of the Obama presidency, based in large part on a review internal White House memoranda not publicly released. The piece features several enlightening vignettes related to health care, including one regarding a proposal never broached in public: “In January, 2010,… [OMB Director Peter] Orszag and Ezekiel Emanuel, the chief of staff’s brother and a health-care adviser, recommended that the government pay federal employees to participate in a pilot program to study the most effective treatments for patients.”
Many would argue that, based upon the policy description included in the article, this policy would represent the worst of both worlds – giving already-overpaid federal bureaucrats additional dollars to sign away their right to access treatments that the government might deem too expensive. But what did President Obama think of it?
Unfortunately I think the political guys are right about how it would be characterized. Let’s go back at it in future years, when the temperature on health care and the economy has gone down.
Sadly, this desire to restrict access to treatment is consistent with the President’s prior history – along with the positions of the advisors who proposed it. In a famous 2009 New York Times interview, the President called for a “difficult democratic conversation” about what he perceived as too much spending on end-of-life care. Orszag was one of the prime architects of Obamacare’s IPAB, which he admitted will have “an enormous amount of potential power” and “the largest yielding of sovereignty from the Congress” in nearly a century. And Emanuel offered the infamous chart for prioritizing scarce medical resources, in a journal article in which Emanuel admitted that his system “discriminates against older people….[However,] age, like income, is a ‘non-medical criterion’ inappropriate for allocation of medical resources.”
As indicated by the quotes above, this Administration has shown a proclivity towards reductions in health spending based upon cost-effectiveness – as well as a willingness to grant bureaucrats virtually unlimited power in the process. The article confirms all those beliefs, while at the same time showing yet another way in which the Administration would use government bureaucrats to restrict access to treatments. Federal workers – and the American people – should take note.