By Jennifer Popik, JD, Robert Powell Center for Medical Ethics
The notion at the heart of the Obama Health Law is that Americans spend too much money on health care, and if there were a way to reduce spending, there would be overall positive impact.
However, two articles from the Washington Post out this week show that when Americans are forced to spend less money on health care, there are going to be grave consequences along the way.
The opinion piece, “The unnecessary test that saved my mother’s life,” by Dr. Jason Wasfy, describes how one inconclusive test after another finally led to a very early diagnosis of his mother’s lung cancer that made the condition treatable.
“Typically, patients do not know they have lung cancer until they notice symptoms such as a cough or weight loss. At that point, lung cancer is usually incurable. My mother was lucky. An unwarranted liver test led to a discovery in the lung, which spotlighted cancer caught early enough to be cured.”
But reducing the number of “unnecessary and expensive tests” has long been a goal of health care cost-cutters. Under the Obama health law’s Independent Payment Advisory Board provision, doctors, hospitals, and other health care providers can essentially be told by Washington just what diagnostic tests and medical care are considered to meet “quality and efficiency” standards– and which are prohibited on the theory that they are not.
Treatment that a doctor and patient deem needed or advisable to save the patient’s life or preserve or improve the patient’s health but which runs exceeds the imposed standards will have to be denied, even if the patient is willing and able to pay for it. Documentation can be found at: www.nrlc.org/uploads/medethics/LifeatRisk112012.pdf
Dr. Wasfy, who is a cardiologist at Massachusetts General Hospital, ultimately concludes
“[M]y mom’s story reminds me just how difficult that task will be for all of us, physicians and patients. Just because a test is not recommended for most patients does not mean that a particular patient would not benefit.”
Insisting on suppressing health care spending is likely to impact medical research as well.
A second article in the Washington Post, by Ariana Eunjung Cha titled, “Americans win Nobel Prize in Medicine,” chronicles how three researchers have “’solved the mystery’ of how cells organize their transport systems with timing and precision.” This research is hoped to lead to future treatments for a wide range of diseases including diabetes, Alzheimer’s, epilepsy, and immunological disorders.
In her article Cha writes,
“While the honorees expressed gratitude for the prize, their comments about their work were tinged with worry about the future of biomedical research after years of cuts in federal funding.
Schekman, whose first major grant was from the National Institutes of Health in 1978, said winning the Nobel Prize made him reflect on how his original proposal might have fared in today’s depressed funding climate. ‘It would have been much, much more difficult to get support,’ he said.
“Likewise, Rothman wondered: ‘Would I have been able to have the initiative, to take the risk? I really am very concerned I would not have been.’
“Südhof said that the funding situation in Washington ‘worries me tremendously.’
“’I do think there’s a danger that … the system will stop and we won’t progress at the rate that would benefit our nation,’ he said.”
The Obama Health Law’s blind insistence on limiting health care spending thus threatens both access to life-saving medical treatment now and innovative cures in the future.
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