WND – by Aaron KleinJonathan Gruber, the embattled former adviser to President Obama on health-care legislation, once conceded the Affordable Care Act would be costly and could lead to rationing and the denial of some treatments, the Daily Caller reported Wednesday.
Gruber, however, is not the only Obama adviser to make such astonishingly candid statements about the health-care law, better known as Obamacare.
Steven Rattner, a top Democrat strategist and donor who served as Obama’s lead auto-industry adviser, conceded in September 2012 that the rationing of heath services under Obamacare is “inevitable.”
Further, WND was first to report the foundations for health-care rationing and even so-called death panels may already have been quietly laid in largely unreported sections of the Obamacare text. There is also within the text of the law preferential treatment based on race, ethnicity and so-called life preferences.
The Daily Caller highlighted an Oct. 2, 2009, lecture that was transcribed into a policy brief in which Gruber conceded Obamacare lacked cost controls and that some treatment may be denied.
“The problem is it starts to go hand in hand with the mandate; you can’t mandate insurance that’s not affordable. This is going to be a major issue,” Gruber admitted during the lecture, which was delivered before the law was passed.
He continued: “So what’s different this time? Why are we closer than we’ve ever been before? Because there are no cost controls in these proposals. Because this bill’s about coverage. Which is good! Why should we hold 48 million uninsured people hostage to the fact that we don’t yet know how to control costs in a politically acceptable way? Let’s get the people covered, and then let’s do cost control.”
Gruber discussed the denial of treatment as a way to make up for the lack of cost controls.
“The real substance of cost control is all about a single thing: telling patients they can’t have something they want. It’s about telling patients, ‘That surgery doesn’t do any good, so if you want it you have to pay the full cost,’” he said.
“There’s no reason the American health-care system can’t be, ‘You can have whatever you want, you just have to pay for it.’ That’s what we do in other walks of life. We don’t say everyone has to have a large-screen TV. If you want a large-screen TV, you have to pay for it. Basically, the notion would be to move to a level where everyone has a solid basic insurance level of coverage. Above that, people pay on their own, without tax-subsidized dollars, to buy a higher level of coverage.”
Obama adviser: ‘We need death panels’
When it comes to such candid statements about Obamacare, Gruber is not alone among the president’s inner circle.
Steven Rattner once advocated that such rationing should target elderly patients while stating, “We need death panels.”
Rattner serves on the board of the New America Foundation, or NAF, a George Soros-funded think tank that was instrumental in supporting Obamacare in 2010.
Rattner was the so-called “car czar,” the lead auto adviser to the Treasury Department under Obama.
In September 2012, Rattner penned an opinion piece in the New York Times titled “Beyond Obamacare” in which he proclaimed “We need death panels” and argued rationing must be instructed to sustain Obama’s health-care plan. His comments have been virtually ignored by traditional media as the president campaigns for a second term.
“We need death panels,” began Rattner. “Well, maybe not death panels, exactly, but unless we start allocating health-care resources more prudently – rationing, by its proper name – the exploding cost of Medicare will swamp the federal budget.”
Continued Rattner: “But in the pantheon of toxic issues – the famous ‘third rail’ of American politics – none stands taller than overtly acknowledging that elderly Americans are not entitled to every conceivable medical procedure or pharmaceutical.”
Rattner lamented that Obama’s Affordable Care Act “regrettably includes severe restrictions on any reduction in Medicare services or increase in fees to beneficiaries.”
Rattner said the numbers don’t add up unless Obamacare utilizes rationing.
“If his Independent Payment Advisory Board comes up with savings, Congress must accept either them or vote for an equivalent package,” stated Rattner. “The problem is, the advisory board can’t propose reducing benefits (aka rationing) or raising fees (another form of rationing), without which the spending target looms impossibly large.”
Rattner singled out elderly patients for benefit cuts.
He wrote: “No one wants to lose an aging parent. And with price out of the equation, it’s natural for patients and their families to try every treatment, regardless of expense or efficacy. But that imposes an enormous societal cost that few other nations have been willing to bear. Many countries whose health care systems are regularly extolled – including Canada, Australia and New Zealand – have systems for rationing care.”
He concluded, “At the least, the Independent Payment Advisory Board should be allowed to offer changes in services and costs.
“We may shrink from such stomach-wrenching choices, but they are inescapable.”
Evidence of death panels in Obamacare?
Besides statements from Obama advisers, the health-care law itself evidences the possibility of future rationing and possibly even death panels, WND found in 2013.
Obamacare called for the establishment of a Patient-Centered Outcomes Research Institute.
The new institute’s purpose is to carry out “comparative clinical effectiveness research,” which is defined in the law as evaluating and comparing “health outcomes” and “clinical effectiveness, risks and benefits” of two or more medical treatments or services.
The purpose of the research is purportedly for the government to determine which treatments work best so that money is not spent on less effective treatments.
Such research was already previously allotted $1.1 billion in Obama’s 2009 “stimulus” package. That legislation first created a Federal Coordinating Council for Comparative Effectiveness Research.
Obamacare now allows for about $3.8 billion in additional funding for effectiveness research, with the establishment of the new Patient-Centered Outcomes Research Institute.
The institute is to be governed by a “board” to assist in identifying research priorities and establishing the research project agenda.
Also weighing in will be an “expert advisory panel” of practicing and research clinicians, patients and experts in scientific and health services research and health services delivery.
A section of Obamacare makes clear the secretary of health and human services may not use research data from the new institute in a manner that treats the life of an elderly, disabled or terminally ill individual as lower in value than that of an individual who is younger, non-disabled or not terminally ill.
However, the dictate comes with a qualifier some many find disturbing.
Obamacare contains largely unreported text that allows the health secretary to limit any “alternative treatments” of the elderly, disabled or terminally ill if such treatments are not recommended by the new research institute.
The qualifier states:
Paragraph (1) shall not be construed as preventing the Secretary from using evidence or findings from such comparative clinical effectiveness research in determining coverage, reimbursement, or incentive programs under title XVIII based upon a comparison of the difference in the effectiveness of alternative treatments in extending an individual’s life due to the individual’s age, disability, or terminal illness.
Paragraph (1) refers to the section that bars the health secretary from valuing the life of an elderly, disabled or terminally ill patient as lower than that of the younger or nondisabled patient.
The qualifier leaves the health secretary with the power to use government-provided research data to determine whether “alternative treatments” are effective in extending the life of the elderly, disabled or terminally ill.
Health-care rationing based on ethnicity?
Another section of Obamacare calls for the new institute to study the effectiveness of treatment in “subpopulations,” including “racial and ethnic minorities, women, age and groups of individuals with different comorbidities, genetic and molecular sub-types, or quality of life preferences.”
The effectiveness of such research has been widely called into question.
In a 2009 study, the CATO Institute raised concern about such government-funded research being politicized or influenced by lobbying.
“Unlike market-generated research, a federal comparative-effectiveness agency would be subject to political manipulation, which could block the generation of any useful research,” wrote CATO.
Continued CATO: “Such research necessarily poses a direct threat to the incomes of pharmaceutical manufacturers, medical device manufacturers and millions of providers. If a government agency produces unwelcome research, those groups will spend vast sums on lobbying campaigns and political contributions to discredit or defund the agency.”
During the “stimulus” debate, Sen. Jon Kyl, R-Ariz., fought the $1.1 billion spending on effectiveness research, spotlighting countries like Britain as cautionary tales.
“Think about this a moment,” Kyl said on the Senate floor. “Do you want Washington bureaucrats, such as those who brought you the AIG mess, making your health care decisions for you and your family?”
Currently, in the U.K., the equivalent to Obamacare’s institute is the National Institute for Health and Clinical Excellence, or NICE.
The New England Journal of Medicine related that “NICE considers treatments cost-effective if their cost-effectiveness ratio is £20,000 ($34,000) per QALY (quality adjusted life year).”
A QALY is an extra year of “quality” life expectancy added based on the treatment.
There were reports that NICE was refusing to fund four new treatments for kidney cancer because they only change a patient’s life expectancy from six months to a year.
Andrew Dillon, NICE chief executive, commented on the denial of one drug for kidney cancer: “Before we recommend any new treatment, we have to be sure the evidence on how well it works is robust and that it is cost effective. We do not want to divert NHS funds to a treatment that costs more but doesn’t help people live longer.”
Writing in Forbes, Sally Pipes, president of the Pacific Research Institute, slammed effectiveness research under Obamacare as a “recipe for cook-book medicine, where the government can pressure doctors into prescribing treatments according to average results rather than an individual patient’s needs and preferences.”
With additional research by Brenda J. Elliott
Read more at http://www.wnd.com/2014/12/presidents-inner-circle-conceded-obamacare-rationing-2/#Ocxi0eeAulkzuoVO.99
Sarah wasn’t lying was she?