Excerpted from WSJ, ” How Washington Rations ObamaCare: a case study in ‘cost-control”, May 19, 2009
Here’s a preview of how health care will be rationed under a nationalized plan with a federal health board making Solomonic decisions based on “comparative effectiveness research”:
Medicare’s central planners decided to deny payment for a new version of one of life’s most unpleasant routine procedures, the colonoscopy.
At issue are “virtual colonoscopies,” or CT scans of the abdomen.
Colon cancer is the second leading cause of U.S. cancer death but one of the most preventable. Found early, the cure rate is 93%, but only 8% at later stages.
Virtual colonoscopies are likely to boost screenings because they are quicker, more comfortable and significantly cheaper than the standard “optical” procedure, which involves anesthesia and threading an endoscope through the lower intestine.
Virtual colonoscopies are endorsed by the American Cancer Society and covered by a growing number of private insurers including Cigna and UnitedHealthcare.
The problem for Medicare is that if cancerous lesions are found using a scan, then patients must follow up with a traditional colonoscopy anyway. Costs would be lower if everyone simply took the invasive route, where doctors can remove polyps on the spot.
As Medicare noted in its ruling, “If there is a relatively high referral rate [for traditional colonoscopy], the utility of an intermediate test such as CT colonography is limited.” In other words, duplication would be too pricey.
One problem is that what “works best” isn’t the same for everyone and invasive procedures are often avoided — slowing early detection.
Full article:
http://online.wsj.com/article/SB124268737705832167.html
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