NCPA - National Center for Policy Analysis


May 20, 2009

In early May 2009, Medicare trustees reported that the program has an "unfunded liability" of nearly $38 trillion.  So Democrats have decided that the way to close this gap is to create a new "universal" health insurance entitlement for the middle class.  And desperate to prevent medical costs from engulfing the federal budget, the program's central planners have decided to deny payment for a new version of one of life's most unpleasant routine procedures, the colonoscopy, say the Wall Street Journal.

For example:

  • 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 percent.
  • Virtual colonoscopies are likely to boost screenings because they are quicker, more comfortable and significantly cheaper than the standard "optical" procedure.
  • Endorsed by the American Cancer Society and covered by a growing number of private insurers, 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.

This is precisely the sort of complexity that the Democrats would prefer to ignore as they try to restructure health care.  Led by budget chief Peter Orszag, the White House believes that comparative effectiveness research, which examines clinical evidence to determine what "works best," will let them cut wasteful or ineffective treatments and thus contain health spending. The problem is that what "works best" isn't the same for everyone, says the Journal. 

Medicare is already the country's largest purchaser of health care.  Private carriers generally adopt its rates and policies, and the virtual colonoscopy decision may run this technology out of the marketplace.  Now multiply that by the new "public option" that Democrats favor, which would transfer millions of patients to a new insurance program managed by the federal government.  Washington's utilitarian judgments about costs would reshape the practice of medicine, says the Journal.

Source: Editorial, "How Washington Rations," Wall Street Journal, May 19, 2009.

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