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Why does Obama want to use elders as guinea pigs for testing medical procedures under IMAC?

Dean Baker:

As part of his health care package, President Obama proposed creating an independent commission of medical experts [IMAC] that would determine the medical procedures for which Medicare will pay. The reason is that patients now receive many costly procedures that provide little or no medical benefit. If we can reduce this waste, we can have large savings, while possibly even improving health outcomes. President Obama describes this as promoting good medicine.

He has a case, but there is one problem with this picture. If the plan is to promote good medicine, why are we just doing it for the elderly receiving Medicare? Why don't we want good medicine for everyone? ...

If the same rules for medical procedures were applied to everyone as to the elderly, it would be far less likely that genuinely useful procedures would be excluded from coverage just to save the government a few dollars. With far more eyes on the process, and far more interested parties, we could have much greater confidence that the panel's decisions were really based on sound evidence.

This raises another important issue about these sorts of medical panels: conflicts of interest. Top medical researchers have a bad habit of taking large consulting fees from folks like pharmaceutical companies, medical supply companies and insurance companies. In many cases, they even hold stakes in these companies.

These medical experts are undoubtedly all very honorable people. However, it simply is not fair to ask the public to trust the health of their loved ones to a medical expert who got a $50,000 check from a company that stands to profit or lose large sums of money depending on their decision. ...

But if the choice is between no panel or a panel comprised of people on the payroll of the drug companies and their ilk, then no panel would be the better outcome. The fact that putting together a conflict-free panel is actually a problem is a testament to the corruption of our health care system. In the country as large as the United States, there should not be any difficulty finding top experts who survive on their salary as a researcher. The vast majority of us survive on considerably less money.

In short, President Obama's plan to weed out ineffective and wasteful medical procedures is a good one. But we should not single out Medicare beneficiaries as guinea pigs in this adventure, and definitely must ensure that the people to whom we entrust our health are not on the industry payroll.

Look, I'm sure there's a very good reason. Let me just put this can of dog food down while I look for it...

NOTE Hat tip, Jawbone.

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Submitted by Anne on

We could call it Micromanaged ObamaCare - well, we could probably call it that even if there is a panel, since, as I understand it, the president's approval of whatever the panel recommends is as good as actual legislation. Oh, sure, Congress can, by joint resolution and within 30 days, override that approval, but I suspect this will be the equivalent of those "free for 30 days and then we'll nick your account for the low, low monthly charge of $24.95 unless you tell us you don't want whatever gimmick we're selling" things that people only notice after they have had hundreds of dollars sucked out of their accounts, and the bank just shrugs.

Does Obama understand why managed care was so bad? Does he understand that one person's unnecessary treatment could improve the quality of life for someone else? Regardless of whether that person is 65 or 95, since chronological age is not necessarily the same as physical age?

Hey, I know - Obama can raise money to pay for crappy health coverage by selling people their very own ice floe - ready and waiting for the day when some panel or some health care board decides our time is up and we must stop draining the lifeblood out of the economy.

Sorry for the rant, but I just cannot believe sometimes the magnitude of this man's ego, that he seriously thinks he, and pretty much he alone, is going to save us from ourselves.


Submitted by hipparchia on

most of those passages i had questions about in my earlier post relate to various experiments in medicare. not only are we going to experiment on old people, it looks like we're not going to allow 'outside interference' with those experiments either, but i haven't gone back to re-read them yet in light of bdblue's information on the apa.

Damon's picture
Submitted by Damon on

I fully support an independent commission of medical experts, in fact, I think it's a necessity. And, I think the idea that we couldn't find any truly independent experts, out there, is a reach. But, I also agree that we shouldn't experiment with just Medicare patients. In the end, though, we absolutely have to have some kind of commission of experts.

The argument against such a thing always turns out to be awfully right-wingish as it always goes to rationing. Rationing happens whether it's done by a universal system or a private one, but at least in a universal system the rationing is inherently more fair. I could see someone marking an argument against such a body in a private-dominated system, but it'd be absolutely foolish to not have such a body in a public/universal system.

What national, public health care systems don't have such a body in existence? Am I missing something, here?

Submitted by lambert on

... I'd agree with you, Damon.

In a system proved untrustworthy, everything packaged as being toward a good end turns sour.