July 18, 2014

The cancer death-panel app

Wesley Smith writes Obamacare Opens Door to Death Panel App

Obamacare’s emphasis on cost-benefit has apparently granted permission for the medical technocrats to conjure all kinds of healthcare rationing schemes.  And the Medical Establishment is apparently playing along.

From, “The Cancer Death-Panel App,” by Robert Goldberg in the NY Post:

The latest innovation in cancer care isn’t a medical breakthrough but an app to ration new drugs. It’ll measure care in terms of what it costs health plans, instead of what it means for patients’ lives. That it’s being developed under the auspices of the American Society for Clinical Oncology, or ASCO, the world’s leading oncology association, is a grim warning about the state of organized medicine.

The app will use an algorithm like those many health plans apply to limit access to innovative treatments. Wellpoint Inc., for one, measures cost-effectiveness by comparing the benefits, side effects and costs of various treatments for specific types of cancer. The ASCO app uses the same benchmarks.

That’s no coincidence. At ASCO’s national conference, Dr. Lee Newcomer, United Healthcare’s medical director, said the “motives [of insurers] are viewed with suspicion when it comes to deciding whether a treatment is cost-effective. So having ASCO play a key role in establishing such guidelines would be crucial to their implementation.”

Translation: Patients are more likely to accept rationing if it comes with a “medical seal of approval.”

Dr. Lowell Schnipper, who heads ASCO’s Value in Cancer Care Task Force, which is building the app, parrots the claim made by Karen Ignagni, president of AHIP (the health-insurance lobby), that new cancer drugs are bankrupting the health system.

That’s not true. Yes, spending on cancer treatments has climbed from $24 billion in 2004 to about $37 billion today. But that’s less than a half a percent of total US health-care spending.

More important: While expensive, since 2004 such innovations were largely responsible for a 40 percent increase in living cancer survivors, from 9.8 million to 13.6 million. The new therapies also saved $188 billion on hospitalizations.

In fact, a new study by Dr. Newcomer himself confirms this result: United Healthcare’s cancer costs dropped as spending on new cancer drugs increased.

Finally, new drugs help people go back to work. The value of the increase in ability to work is 2.5 times what we spend on new therapies.

The app’s biggest problem, though, is that it’s one-size-fits-all: It treats all patients as the same, ignoring the genetic variation in patient response that a new class of “targeted” cancer drugs will soon address.
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Dig a bit deeper, and it’s clear that Schnipper and his allies have a more ideological motivation. He talks of limiting spending on new treatments as a way to make “the health-care system, not just the cancer system, more rational and just.”

And this line of thinking does away with the Hippocratic Oath. No longer is the doctor’s first obligation “to apply for the benefit of the sick, all measures that are required.” Instead, Schnipper believes three months of added life “is not a large enough benefit to trump the greater benefits to many that would have to be foregone to provide it.”

In fact, he regards the premium that Americans place on life as a character defect, observing, “Other cultures do not seem to view the postponement of death by a few months” the same way we do…….
Posted by Jill Fallon at July 18, 2014 12:21 AM | Permalink