Of NICE and Men
7th July 2009
Speaking to the American Medical Association last month, President Obama waxed enthusiastic about countries that “spend less” than the U.S. on health care. He’s right that many countries do, but what he doesn’t want to explain is how they ration care to do it.
While the guidelines are complex, NICE currently holds that, except in unusual cases, Britain cannot afford to spend more than about $22,000 to extend a life by six months. Why $22,000? It seems to be arbitrary, calculated mainly based on how much the government wants to spend on health care. That figure has remained fairly constant since NICE was established and doesn’t adjust for either overall or medical inflation.
The NICE precedent also undercuts the Obama Administration’s argument that vast health savings can be gleaned simply by automating health records or squeezing out “waste.” Britain has tried all of that but ultimately has concluded that it can only rein in costs by limiting care. The logic of a health-care system dominated by government is that it always ends up with some version of a NICE board that makes these life-or-death treatment decisions. The Administration’s new Council for Comparative Effectiveness Research currently lacks the authority of NICE. But over time, if the Obama plan passes and taxpayer costs inevitably soar, it could quickly gain it.
July 7th, 2009 at 09:05
See also today’s Belmont Club: http://pajamasmedia.com/richardfernandez/2009/07/06/electing-god/