British Doctor’s View of Obama’s Healthcare: This Health Care ‘Reform’ Will Kill Thousands
I feel like the libs have all the proof they need that socialized medicine will NOT work, but they are just ignoring it!!!! What will make them listen???????????????
Karol Sikora: This health care ‘reform’ will kill thousands
One of the more unproductive elements of President Obama’s stimulus bill is the $1.1 billion allotted for “comparative effectiveness research” to assess all new health treatments to determine whether they are cost-effective. It sounds great, but in Britain we have had a similar system since 1999, and it has cost lives and kept the country in a kind of medical time warp.
As a practicing oncologist, I am forced to give patients older, cheaper medicines. The real cost of this penny-pinching is premature death for thousands of patients — and higher overall health costs than if they had been treated properly: Sick people are expensive.It is easy to see the superficial attraction for the United States. Health-care costs are rising as an aging population consumes ever-greater quantities of new medical technologies, particularly for long-term, chronic conditions, such as cancer.
As the government takes increasing control of the health sector with schemes such as Medicare and SCHIP (State Children’s Health-care Insurance Program), it is under pressure to control expenditures. Some American health-policy experts have looked favorably at Britain, which uses its National Institute for Clinical Excellence (NICE) to appraise the cost-benefit of new treatments before they can be used in the public system.
If NICE concludes that a new drug gives insufficient bang for the buck, it will not be available through our public National Health Service, which provides care for the majority of Britons.
There is a good reason NICE has attracted interest from U.S. policymakers: It has proved highly effective at keeping expensive new medicines out of the state formulary. Recent research by Sweden’s Karolinska Institute shows that Britain uses far fewer innovative cancer drugs than its European neighbors. Compared to France, Britain only uses a tenth of the drugs marketed in the last two years.
Partly as a result of these restrictions on new medicines, British patients die earlier. In Sweden, 60.3 percent of men and 61.7 percent of women survive a cancer diagnosis. In Britain the figure ranges between 40.2 to 48.1 percent for men and 48 to 54.1 percent for women. We are stuck with Soviet-quality care, in spite of the government massively increasing health spending since 2000 to bring the United Kingdom into line with other European countries.
Having a centralized “comparative effectiveness research” agency would also hand politicians inappropriate levels of control over clinical decisions, a fact which should alarm Americans as government takes ever more responsibility for delivering health care — already 45 cents in every health-care dollar. In Britain, NICE is nominally independent of government, but politicians frequently intervene when they are faced with negative headlines generated by dissenting terminal patients.
For years, NICE tried to block the approval of the breast cancer drug Herceptin. Outraged patient groups, including many terminally ill women, took to the streets to demonstrate. In 2006, the then-health minister suddenly announced the drug would be available to women with early stages of the disease, even though it had not fully gone through the NICE approval process.
A more recent example was the refusal to allow the use of Sutent for kidney cancer. In January, NICE made a U-turn because of pressure on politicians from patients and doctors. Twenty-six professors of cancer medicine signed a protest letter to a national newspaper — a unique event. And yet this drug has been available in all Western European countries for nearly two years.
In Britain, the reality is that life-and-death decisions are driven by electoral politics rather than clinical need. Diseases with less vocal lobby groups, such as strokes and mental health, get neglected at the expense of those that can shout louder. This is a principle that could soon be exported to America.
Ironically, rationing medicines doesn’t help the government’s finances in the long run. We are entering a period of rapid scientific progress that will convert previous killers such as heart disease, stroke and cancer into chronic, controllable conditions. In cancer treatment, my specialty, the next generation of medicines could eliminate the need for time-consuming, expensive and unpleasant chemo and radiotherapy. These treatments mean less would have to be spent later on expensive hospitalization and surgery.
The risks of America’s move toward British-style drug evaluation are clear: In Britain it has harmed patients. This is one British import Americans should refuse.
Karol Sikora, a practicing oncologist, is professor of cancer medicine at Imperial College School of Medicine, London, and former head of cancer control at the World Health Organization.