Saturday, September 12, 2009
Not So NICE
In any discussion of health care policy in Washington, the name "NICE" comes up sooner or later. NICE is the acronym (more or less) for the National Institute for Health and Clinical Excellence, which is the decision-making core--the CPU, you could call it--of the UK's National Health Service.
And so it's useful to look in on how NICE, and the NHS, are performing in the UK, because that could provide clues to how an American NICE might function.
Here's recent headline, for example, in The Daily Mail: "Restrictions on prescription of osteoporosis drugs 'defy belief', says leading doctor."
According to the piece:
Professor David Reid, an expert on brittle bones, said the rules are so stringent that GPs are often prevented from giving alternative treatments to those suffering side-effects from their pills.
A once-a-year jab that could save thousands from the misery of broken bones is also not going to be assessed for use on the NHS in England and Wales for at least three years, according to Professor Reid, despite being available in Scotland
And here's another article, in The Northern Echo, headlined: "Nice under fire for decision not to fund liver cancer drug." As the article starts out:
A NORTH-EAST liver cancer specialist says she is very disappointed that desperately-ill patients will not benefit from a new life-extending drug which is widely available across Europe.
The National Institute for Health and Clinical Excellence, Nice, today publishes draft guidance about the use of liver cancer drug Nexavar.
And so it's interesting to see that versions of NICE are already floating around in the US. For example, there's MedPAC, an independent agency established by an act of Congress in 1997 to advise Congress on Medicare issues. Since Medicare is projected to spend $515 billion in fiscal year 2010, MedPAC could have a lot of power.
In a book he published last year, Critical: What We Can Do About the Health-Care Crisis, Tom Daschle, (D-SD) the former Senate Majority Leader, called for the creation of a "Federal Health Board," modeled after the Federal Reserve Board, America's central bank. The idea being that such a body, like the Fed, would be substantially insulated from public pressure. In other words, like NICE.
The idea has long enjoyed enormous support among America's chattering classes. Here's Wesley Smith dissecting a pro-rationing story that appeared in The New York Times late last year.
And so now, in 2009, there's also Federal Coordinating Council for Comparative Effectiveness Research, which received $1.1 billion in the stimulus bill. Joseph Ashby, writing for American Thinker, can take it from here:
The Council is the brain child of former Health and Human Services Secretary Nominee Tom Daschle. Before the Porkulus Bill passed, Betsy McCaughey, former Lieutenant governor of New York, wrote in detail about the Council's purpose.
Daschle's stated purpose (and therefore President Obama's purpose) for creating the Council is to empower an unelected bureaucracy to make the hard decisions about health care rationing that elected politicians are politically unable to make. The end result is to slow costly medical advancement and consumption. Daschle argues that Americans ought to be more like Europeans who passively accept "hopeless diagnoses."
McCaughey goes on to explain:
Daschle says health-care reform "will not be pain free." Seniors should be more accepting of the conditions that come with age instead of treating them.
That's the future the Obamans have in mind. Deal with it.
Posted by James P. Pinkerton at 7:24 PM