Throughout the health care debate, conservatives warned what a government takeover of our health care would mean for America's health care system. Conservatives said government intervention would restrict access to affordable and quality care, government spending and premiums would skyrocket and Americans would be forced out of their current health care plans. Important decisions would not be made by doctors and their patients but through bureaucrats in Washington who would put cost above quality care in their decision-making.
President Obama and Democrats rejected these conclusions. The President promised "you will have not only the care you need, but also the care that right now is being denied to you -- only if we get health care reform." But last month President Obama nominated Dr. Donald Berwick to head of Center for Medicare and Medicaid Services. A strong advocate for U.K. socialized health care system and rationing health care, Dr. Berwick has said, "it's not a question of whether we will ration health care. It is whether we will ration with our eyes open." As head of the CMS, Berwick will oversee health care of over 100 million Americans with a budget of $800 billion annually. President Obama had to circumvent the Senate and use a recess appointment in order to try to hide Dr. Berwick's radical views.
In the coming months, there will be a big test on rationing care. Medicare may end its coverage of two successful anti-cancer drugs, Provenge and Avastin. Provenge is used to extend the life of patients with prostate cancer, while Avastin, the world best selling anti-cancer drug, helps to prevent the spread of breast cancer in late stages.
CMS is currently reviewing Provenge to see whether they will cover the drug. The reason: it costs $23,000 per month and on average costs $93,000 in total. Instead of looking at the track record of the effectiveness of the drug, the government has decided to determine whether it is worth the high cost. All of this comes after the President has said he does not "want government bureaucrats meddling in your health care." The American Society of Clinical Oncology, representing 28,000 cancer doctors, has sent a letter to CMS urging them to continue their 80% reimbursement rate of the drug.
Avastin is under similar review, but this time by the FDA. The FDA advisory panel just voted 12-1 to stop backing the drug. The FDA says they reviewed the drug effectiveness
given recent studies that have shown it has little effect on extending the life of women with breast cancer but possibly high side effects. But the Washington Post noted on August 16th:
"Federal regulators are considering taking the highly unusual step of rescinding approval of a drug that patients with advanced breast cancer turn to as a last-ditch hope. The debate over Avastin, prescribed to about 17,500 women with breast cancer a year, has become entangled in the politically explosive struggle over medical spending and effectiveness that flared during the battle over health-care reform: How should the government balance protecting patients and controlling costs without restricting access to cutting-edge, and often costly, treatments?... The FDA is not supposed to consider costs in its decisions."
A spokesperson for the FDA said that the drug should remain an option for cancer patients but their actions will most likely lead to insurers to stop coverage of the drug, making it extremely difficult for it to remain as a legitimate option for cancer patients.
Clearly the FDA has now made cost a factor in its review of drugs, even though the FDA clearly states on their web site they are only "responsible for protecting the public health by assuring the safety" of drugs. According to the American Society of Clinical Oncology, Medicare statute section 1861(t)(2)(A) states Medicare must cover any drug that is approved by the FDA. This is completely unprecedented. It would be the first time Medicare would not provide coverage for a cancer treatment drug approved by the FDA.
Susan G. Komen and the Ovarian Cancer National Alliance, have co-authored a letter to the FDA asking them to continue support of the drug and warning that rescinding their approval would inevitably lead to a decline in its use by patients and coverage by insurance companies.
According to the UK Telegraph, the UK NHS health system is also currently reviewing Avastin, Republican Senator David Vitter of Louisiana responded to the news saying, "I shudder at the thought of a government panel assigning a value to a day of a person's life," he said. "It is sickening to think that care would be withheld from a patient simply because their life is not deemed valuable enough…I fear this is the beginning of a slippery slope leading to more and more rationing under the government takeover of health care that is being forced on the American people." According to the American Cancer Society, 40,170 women lost their life to breast cancer in 2009.
Rationing care is exactly why government should not have control over our health care system. They should not make decisions for individuals, but rather decisions like this should remain between the doctor and his or her patient. The pattern of putting cost above high quality care is dominant in Europe, which is why the US currently has a higher cancer survival rate than any European country.
We encourage Dr. Berwick to refrain from forcing rationing on the American health care system. Rationing is a recipe for disaster that will lead to higher mortality rates and lower quality health care. ObamaCare should be repealed and replaced with real reforms that cut costs, lower premiums and expand coverage for the uninsured.
Source: American's for Prosperity
Date Published: August 17, 2010
