Rationing Health Care in Oregon
BY: HOPE LANDSEM
Liberal states often preview health-care central planning before the same regulations go national, which ought to make an Oregon cost-control commission especially scary. On Thursday a state board could change Oregon's Medicaid program to deny costly care to poor patients who need it most.
Like most such panels, including the Affordable Care Act's Independent Payment Advisory Board, the Oregon Health Evidence Review Commission, or HERC, claims to be merely concerned with what supposedly works and what doesn't. Their real targets are usually advanced, costly treatments. That's why HERC, for example, proposed in May that Medicaid should not cover "treatment with intent to prolong survival" for cancer patients who likely have fewer than two years left to live. HERC presents an example to show their reasoning for such a decision: "In no instance can it be justified to spend $100,000 in public resources to increase an individual's expected survival by three months when hundreds of thousands of Oregonians are without any form of health insurance."
Amazingly enough, the Affordable Care Act quashed that one. The law says coverage decisions cannot discriminate against people because of their diagnoses and life expectancies.
So HERC changed a few words of its proposal. Before, the plan would have limited treatment based on life expectancy. Now, the plan will determine whether an individual continues to receive potentially life-saving treatment based on the severity of the illness, using ambiguous performance statuses, a scale that tries to quantify a cancer patient's well-being. Some difference.
This is a recurring theme in HERC's Medicaid overhaul. The commission also suggested guidelines that would limit to once a week the number of times some diabetics could check their blood sugar, down from the three tests a day the American Diabetes Association recommends now. Outrage from diabetics, not to mention medical experts, forced the commission to postpone that vote.
The public isn't receiving the cancer proposal any better. In a letter to HERC, a Willamette Valley Cancer Institute and Research Center patient navigator, a trained health-care worker responsible for educating cancer patients and guiding them through various treatment options, writes that "patients deserve treatment that is available based on the best evidence, not on a timeline." We'll learn today if HERC is willing to restrict potentially life-saving treatment in favor of the left's one-size-fits-all health approach.
