Horror Story
Excerpts from the Wall Street Journal Review and Outlook Section for Today, March 18. If you want to read the whole story (I really didn't take out very much) you have to be a member of WSJ.
The Pro-Diabetes Board
Washington state targets modern medicine. Coming soon to D.C.
The future tragedies of government health care will include today's
many warnings about how it operates in practice. The
subsidize-mandate-overregulate insurance model is imploding in
Massachusetts. Then there's Washington state, where a government
board may decide that modern medicine is too expensive for kids with
diabetes.
Seriously. In 2006, Washington created a board to scrutinize the
cost-effectiveness of various surgeries and treatments, known as the
Health Technology Assessment program. At a hearing today, the panel
will debate glucose monitoring for diabetic children under 18. In
other words, the board is targeting the fundamental standard of
diabetes care that has been the established medical consensus for at
least three decades.
This state issue deserves far more scrutiny, if only because
ObamaCare and the stimulus devoted billions of dollars to comparative
effectiveness research.... In theory, it sounds great. But the Health
Technology Assessment is an example of how comparative effectiveness
will work in the real world, as the political system tries to find
ways to restrict or limit treatment to control entitlement spending.
(Diabetes) Patients
do so either with finger sticks that are read by an electronic meter
or continuous glucose monitors that track blood sugar levels
virtually in real time.
The Health Technology Assessment has homed in on both technologies,
claiming that the "effectiveness and optimal frequency of
self-monitoring of blood glucose in patients is controversial." Not
among physicians. But in a recent report, the panel suggests that
there isn't enough "evidence" to support monitoring among childhood
and adolescent diabetics, and that the randomized controlled trials
that have been conducted aren't high quality.
Such a trial would violate medical ethics: A group of children would
essentially be required to not monitor glucose putting them at risk
for long-run complications from too high or low blood sugar,
including seizures and even death. Following a landmark 1993 trial on
tight glycemic control, and the vastly improved outcomes since, the
clinical benefits of intensive management are irrefutable.
Except, apparently, to a government board looking to scrimp.
Washington's Health Technology Assessment makes decisions for
state-subsidized health care, including Medicaid beneficiaries,
public employees and prisoners about 750,000 people. If it bans
continuous monitors or limits finger sticks to a certain daily number
at today's hearing, pediatric patients and their parents will lose
the tools and the more and better information they need to manage
their disease.
More to the point, as shown by the arbitrary Washington state method,
political comparative effectiveness isn't about informing choices.
It's really about taking away options.
Which brings us from Washington state to Washington, D.C. The Health
Technology Assessment program's director, Leah Hole-Curry, was
appointed last year as a governor of the comparative effectiveness
board established by ObamaCare. The national board is known as the
Patient-Centered Outcomes Research Institute, yet at an early meeting
in November, Ms. Hole-Curry and the other 14 governors debated
whether or not patients were the institute's "primary constituents."
Now this agenda is on autopilot. The institute is built on
self-executing funding that is, not subject to annual appropriations
like other federal programs and dedicated taxes on insurers. At the
very least Americans deserve some honesty about who these people are
and what they favor.
The Pro-Diabetes Board
Washington state targets modern medicine. Coming soon to D.C.
The future tragedies of government health care will include today's
many warnings about how it operates in practice. The
subsidize-mandate-overregulate insurance model is imploding in
Massachusetts. Then there's Washington state, where a government
board may decide that modern medicine is too expensive for kids with
diabetes.
Seriously. In 2006, Washington created a board to scrutinize the
cost-effectiveness of various surgeries and treatments, known as the
Health Technology Assessment program. At a hearing today, the panel
will debate glucose monitoring for diabetic children under 18. In
other words, the board is targeting the fundamental standard of
diabetes care that has been the established medical consensus for at
least three decades.
This state issue deserves far more scrutiny, if only because
ObamaCare and the stimulus devoted billions of dollars to comparative
effectiveness research.... In theory, it sounds great. But the Health
Technology Assessment is an example of how comparative effectiveness
will work in the real world, as the political system tries to find
ways to restrict or limit treatment to control entitlement spending.
(Diabetes) Patients
do so either with finger sticks that are read by an electronic meter
or continuous glucose monitors that track blood sugar levels
virtually in real time.
The Health Technology Assessment has homed in on both technologies,
claiming that the "effectiveness and optimal frequency of
self-monitoring of blood glucose in patients is controversial." Not
among physicians. But in a recent report, the panel suggests that
there isn't enough "evidence" to support monitoring among childhood
and adolescent diabetics, and that the randomized controlled trials
that have been conducted aren't high quality.
Such a trial would violate medical ethics: A group of children would
essentially be required to not monitor glucose putting them at risk
for long-run complications from too high or low blood sugar,
including seizures and even death. Following a landmark 1993 trial on
tight glycemic control, and the vastly improved outcomes since, the
clinical benefits of intensive management are irrefutable.
Except, apparently, to a government board looking to scrimp.
Washington's Health Technology Assessment makes decisions for
state-subsidized health care, including Medicaid beneficiaries,
public employees and prisoners about 750,000 people. If it bans
continuous monitors or limits finger sticks to a certain daily number
at today's hearing, pediatric patients and their parents will lose
the tools and the more and better information they need to manage
their disease.
More to the point, as shown by the arbitrary Washington state method,
political comparative effectiveness isn't about informing choices.
It's really about taking away options.
Which brings us from Washington state to Washington, D.C. The Health
Technology Assessment program's director, Leah Hole-Curry, was
appointed last year as a governor of the comparative effectiveness
board established by ObamaCare. The national board is known as the
Patient-Centered Outcomes Research Institute, yet at an early meeting
in November, Ms. Hole-Curry and the other 14 governors debated
whether or not patients were the institute's "primary constituents."
Now this agenda is on autopilot. The institute is built on
self-executing funding that is, not subject to annual appropriations
like other federal programs and dedicated taxes on insurers. At the
very least Americans deserve some honesty about who these people are
and what they favor.
Replies to This Discussion
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Permalink Reply by MossDog on -
The problem with blaming the other side for a bill that in the end will end up costing us money ( I think we can SAVE money if done right) is that the left had a super majority. They could have crammed through whatever they wanted (just like they crammed through the POS we are currently talking about).
Jean as you lament those who are working full time for "Mr. Murdoch, the brothers Koch or someone else in the propaganda business". you have to realize that by simply expressing that sentiment anyone who knows anythig about politics in general will propose (whether accurately or not) you are just repeating the Left's line. This in turn makes everything you are arguing irrelevant in their eyes which does you no good in posting in the first place. Those who think like you will say "good" but those on the other side will simply disregard your arguments.
I am an independent. As far as I see it both sides of the isle are very similar. They promise a lot but deliver little (anyone remeber Obama promising the healthcare debate would be on CNN?) I think it is time for all Americans to step out of the right vs left and stand up for what they believe in. Stop perpetuating the right vs left sentiment. In the end they are both the same. Out to tell as many lies as possible to get votes and in the end do whatever ends up making them the most money/ protects their interests.
I simply do not accept the "this bill is better than nothing" mantra. This bill will end up making a bad situation even worse. We needed actual reform, not adding people to an already broken system.
Obama screwed himself. No one needs to blame him because it is quite clear he made a lot of promises that he broke (transperency, bipartisinship etc..). He dug his own grave....... -
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Permalink Reply by LaGuitariste on -
They didn't want to "... cram through whatever they wanted..."
Instead, they compromised, compromised, compromised in their (FAILED) effort to get the Republicans to cooperate.
Calling what was passed "ObamaCare" is ridiculous. It should be called "RepubliCare" if anything at all. -
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Permalink Reply by Natalie ._c- on -
As far as I'm concerned, Obama's biggest mistake as President was to bend over backwards to try to get totally obstructionist and refractory Republicans to cooperate so as to make a bipartisan deal. His plan wasn't so bad until Republicans twisted and mangled it. Even the non-partisan Budget Office said it would have saved money if it had been enacted as planned.
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Permalink Reply by LaGuitariste on
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"Stop perpetuating the right vs left sentiment. In the end they are both the same."
I'm sorry, but that's like saying that Kaddafi and the U.N. are both the same because they are both using bombs right now.
Politics isn't just about tactics; it's about intent.
What is the intent of the Koch brothers? What is the intent of John Stewart? What is the intent of President Obama? What is the intent of Michelle Bachman?
It's not enough to just throw your hands up and say, "Oh, all those people in politics are just the same." We have to look closely at what they intend to accomplish, their end-game, their goals and objectives, who is funding them and why, as well as how successful they are at sticking to their principles, persuading others to do the right thing (even if it hurts their bottom line a little bit), making reasonable compromises (e.g. not capitulating before even discussing single-payer), etc.
My intention is to get excellent healthcare to every, single American at the most sensible, affordable cost possible without sacrificing quality.
Does this mean that everyone will be able to get botox, tummy tucks and a massage every morning? Um. Nope. Does this mean that we'll have to have "death panels", people waiting for five years to have necessary surgery and doctors working for minimum wage and food stamps. Ummmm...no. Absolutely not. -
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Permalink Reply by MossDog on
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Jean- Did you know that in 2010 of all health related contributions (including Big Pharm) the Democrats took in a cool 75 million dollars? Republicans took in about 100 million dollars. From what I can see as far as this debate goes they are BOTH on the take. This leads me to believe they are looking out for THEMSELVES and not me.
Problem is there are too many there who have been there for too long and are more than willing to show any newbie’s how to take full advantage of the system they have set up. To assume you can judge a politicians intent is stretching it a little thin. The one thing I can say for sure they are worried about- $$$$$. Where does that leave you and me? Republicans are everything you rail against I am with you there. But it would be in your best interest to take a good look at your side of the aisle as well. They may not be a squeaky clean as you might wish.
Massachusetts has already shown us this current healthcare system will not work and now we are going to attempt it on an even larger scale? You say Germany has it right. Why didn't the Dems propose a system more like theirs? Could it be they were more concerned with what was politically expedient than what was right? -
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Permalink Reply by Brunetta on -
:Howling about "ObamaCare" and pitting the insured against the uninsured isn't going to fix anything. Having everyone covered, a lot more medical staff and a lot less profiteering and senseless paper shuffling will go a long way towards ending the healthcare rationing that we now accept as "normal" -- normal, that is, unless we're the people who can't get any health coverage.I agree, Jean V
We are in the midst of very divisive perioid in our nation's political culture:There are multiple states facing cuts in funding to schools, hopspitals,m prisons libraries and legislations peniding that change how pulbic sector workers ( teachers, firefighters, helalthcare workers, govenrment workers ,firefighter, police officers, etc) negotiate for and recieve insurance benfits and conditions . Many people, legislators and governors included, beleive that public workers are 'too spoiled" by their unions and their pension and sick leaver] policies.. So again those who are in the public sector are pited against those who work private sector jobs.. And the public sector workers are made the scapegoats for the unbalanced budgets
I do not bleive that the health-are initiative is what wimit saccess to proper diabetes care. tTe profit-0based health insurance congolomerates,funders of are at the source of this, I beleieve. I have excellent insurance, Now, as a current employee of a schol district. I am reiring in June, and I am researching whether I will be able to keep my current level of type one care ( CGM, Insulin oump)while under the group insurance funded by my state"s reitirerment board. They are facing cuts too I am hoping and praying that I will not be forced to go back to 6 shots a day , no CGMS;and a limiit on my test strips, , upon reitrement, due to a change in what the onlky insurance I can get offers.... I know some peple who are literally sick and tired but keep working to get insurance coverage.... What will they do if insurance coverages change whether they continue to work or not?
I am not worried, but concerned.... Even if I cannot gert my pump supplies funded through post-retirement insurance, God will make a way for me :He always has and always will,,,,,,
God Blerss
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Permalink Reply by jojo on -
Gee, right on!! Totally agree. I am a nurse in the northeast and see all of the above that you are talking about.
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Permalink Reply by MossDog on
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I agree that waste is a HUGE problem. Do you honestly believe the government trying to "fix" healthcare is really going to solve this problem?
I am NOT trying to pit the uninsured against the insured AT ALL. If the government is going to get involved I would be much more apt to feel like this is going to work out if there was a single payor source and everyone get's the same insurance including all the slimeballs that wrote the current bill (amazing how they and their friends get a special exemption that they do not have to be involved in this new brand of healthcare).
As far as I can see with the new health care bill, every concern you have in regards to paper shuffling and waste just got amplified by about 30 million people. Do you think they will try to get rid of the waste? Nope that is too difficult. They are going to start saying- boy those PWD sure are expensive we should not cover these expensive strips, insulin , and CGMS machine's.
Healthcare reform needs to deal with fraud and waste. Can you point me to where this is a prominent in the new bill?
And don't get me started about the lack of funds allocated to prevention.
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Permalink Reply by LaGuitariste on
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I believe in making Medicare universal -- I want everyone from the President, Vice President, Senators and Cabinet members to the local homeless meth addict and teen mother to be on the exact, same, universal, single-payer health system.
That is the only way we'll ever get true value for our dollar and true quality in healthcare. If Mrs. Trump, Mrs. Murdoch, Mrs. Obama, my niece and the gal living under the viaduct in her van all have the exact same coverage for their contraceptives, their pregnancies, their preventative care, their infant's care, then we'd get the waste and fraud out pronto and have a vastly better system for everyone.
Would we pay hundreds of millions in salaries to three-martini-lunch suits who add nothing to the process of providing healthcare? Not it if meant a cut in services to Mrs. Trump.
Would we turn a blind eye to waste and fraud? Not if it meant less quality care for Mrs. Murdoch.
Would we negotiate drug prices? You BET we would.
Level the darn playing field and watch all the clamoring for more medical school slots, more nursing schools, fewer paper shufflers and less of the current, obscene profiteering.
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Permalink Reply by LaGuitariste on
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How exactly is a comment from a report written in Washington STATE somehow Obama's fault? How can we fix a problem if we won't even pay attention to the actual source of the problem?
All this flailing around and honking, "ObamaCare! ObamaCare! Aaaak!" may be good for FOX news ratings and Mr. Murdoch's other enterprises (i.e. the Wall Street Journal and the Republican Party) but it is doing nothing to improve healthcare for diabetics, or anyone else.
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