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Influential Government
Working Group Puts (June 15, 2006) The prospect of more government control of health care (a reality that has been expanding incrementally in the United States for several decades), up to and including a complete federalization of all things medical, is appearing more and more likely. Why should anyone interested or working in the field of alternative medicine care about such a topic? The answers should be self-evident but probably aren't, given the paucity of attention to the subject of government-run medicine in today's alt med, or as it prefers to be called, “CAM” (complementary alternative medicine), community. The answers include the fact that government control of health care is stifling to innovation and anathema to freedom and choice, especially when one's choices involve alternative or unconventional options that are unpopular with the mainstream. With over three decades of experience reporting on and involved in areas including the politics of medicine, medical innovation, health care freedom, and personal autonomy, this writer is extremely concerned about the daily reports that chart the radical expansion of the power and reach of Medicine, Inc. (the monopoly/oligopoly of government and private industry) that is looming darkly on the political horizon. The day is probably not very far off when a “cookbook” of allopathic (and a few alt med-light CAM) therapies endorsed and mandated by the orthodox medical Establishment is enforced by a rigid, no-opt-out system of total electronic monitoring, payment, and control by an all powerful centralized government medical authority. One recent report of interest, which has received scant attention in the media, involves the recommendations of something called the Citizens' Health Care Working Group. This prestigious and influential commission was mandated by a law, the Medicare Prescription Drug, Improvement, and Modernization Act Of 2003, passed by the Congress. The working group provision, section 1014, was buried on page 156 of the 163 page long summary of the law, totally overshadowed by the legislation's primary purpose: the expansion of Medicare to include a prescription drug benefit. Speaking about the 2003 Medicare law as a paid consultant for Pfizer, Inc. (“the world's largest research-based pharmaceutical company”), former Sen. Bob Dole (R-KS), according to The Hill (February 26, 2004), said that it “represents the greatest expansion of Medicare benefits since its inception” in 1965. At the top of the Citizens' Health Care Working Group is a 14-member committee selected by Comptroller General of the U.S. David Walker from 530 applicants. According to the group's Web site, “The members represent many regions of the country and a broad range of health care perspectives, including consumers, providers, employers and workers.” That means they are clinicians, health care workers, medical financing experts, medical industry managers, academicians, and a labor union representative (the “consumer”), most of whom are from the political left and all of whom have a major investment in the conventional medical status quo. As the AP described it, the “blue ribbon panel” was “established by Congress with the mandate of finding out what Americans want when it comes to health care.” It is not a stretch to see the group's conclusions as a validation (by supposed public opinion sampling) of the agenda they started out with – namely to accelerate the push towards government-provided and -controlled universal health care. On June 1, the working group released its interim recommendations (accessible as a pdf file), “based on input received [during the past year] from community meetings, public hearings, and online responses.” The 13-page report's “Preamble” (the use of the word seems to imply a document comparable somehow to the U.S. Constitution) notes, “We have spent 15 months reading, listening and learning about U.S. health care from a wide range of perspectives. We have held 6 hearings with experts, stakeholders, scholars, public officials and advocates. We have conducted 31 community meetings, as well as special topic meetings and sponsored events, in more than 50 communities across the nation. Members attended meetings in 30 states and the District of Columbia. We have reviewed all the major public opinion polls focused on health care conducted between 2002 and 2006. Citizen responses to the Working Group’s internet polls (over 10,000 as of May 15) were studied. Finally, we have read close to 5,000 individuals’ commentaries on health care matters submitted by residents of this country.” The Preamble's next two sentences suggest that it will be highly critical: “A picture has been sketched for us of a health care system that is unintelligible to most people. They see a rigid system with a set of ingrained operating procedures that long ago became disconnected from the mission of providing people with humane, respectful and technically excellent health care.” The report notes that the working group is charged by the 2003 Medicare law with addressing at least four questions: -What health care benefits and services should be provided? -How does the American public want health care delivered? -How should health care coverage be financed? -What trade-offs are the American public willing to make in either benefits or financing to ensure access to affordable, high quality health care coverage and services? Judging by its interim recommendations which mention the goal of “mov[ing] to universal coverage,” it seems likely that the working group, its final recommendations, and the political Kabuki theater involving the President, the Congress, special interests, the media, and other players that will inevitably follow will provide bullet proof cover for the variety of powerful economic and political forces that have come together to completely centralize and federalize all health care – including “physical, mental, and dental” care which the working group considers essential parts of any national plan - in the U.S. The working group believes that American health care is in need of serious “reform,” and that the reform “should be guided by principles that reflect values of the American people.” Among the principles it defines: “It should be public policy, established in law, that all Americans have affordable health care coverage. Assuring health care is a shared social responsibility. This includes, on the one hand, a public responsibility for the health and security of its people, and on the other hand, the responsibility of everyone to contribute. A defined set of benefits is guaranteed, by law, for all, across their lifespan, in a simple and seamless manner; the benefits are portable and independent of health status, working status, age, income, or other categorical factors that might otherwise affect insurance status. . . All Americans will have access to a set of core health care services across the continuum of care throughout the lifespan.” The “Core benefits/services” will be “specified. . . by a public/private entity whose members are appointed” and will “tak[e] into account evidence-based science and expert consensus regarding the effectiveness of treatments.” The group next specifies six “interim recommendations.” Not surprisingly, the first one, as the report already notes but repeats again in bold text, is “It should be public policy that all Americans have affordable health care.” All of the group's research and public opinion sampling reportedly confirmed that “large majorities of people [are] willing to make additional financial investments in the service of expanding the protection against the costs of illness and the expansion of access to quality care.” In light of the fact that the cost of conventional medical care in the U.S. is currently about $7,000 annually for every person in the country (over $2 trillion a year total), that finding is especially curious. If health care is not already “affordable,” will it be more affordable if people are forced “to make additional financial investments?” The report goes on, “We recommend adopting financing strategies for these recommendations that are based on principles of fairness, efficiency, and shared responsibility. These strategies should draw on dedicated revenue streams such as enrollee contributions, income taxes or surcharges, 'sin taxes', business or payroll taxes, or value-added taxes that are targeted at supporting these new health care initiatives.” [emphasis added] There is now a “90-day public comment period” on the recommendations the working group came up with. After that period ends, the group “will submit to Congress and the President a final set of recommendations. The law specifies that the President shall submit a report to Congress on the recommendations within 45 days of receiving them, and designates five congressional committees that will hold hearings on that report and the recommendations.” Presumably, legislation to establish universal health care will follow. Several times, the working group's June 1 interim recommendations cite “health information technologies and electronic medical record systems” and “evidence-based science” (“evidence-based” is an especially hot buzz word these days for health care reformers) as the key determinants of what kinds of treatment options will be available. These two citations should raise alarms for anyone concerned with freedom, choice, and common sense. The Citizens' Council on Health Care (CCHC) in December 2004 released a report "How Technocrats are Taking Over the Practice of Medicine: A Wake-up Call to the American People." A CCHC news release about the report describes it as “shin[ing] a bright light of openness on the terms 'evidence-based medicine' and 'best practices,' including the purposes of proponents and the concerns of critics.” According to Twila Brase, CCHC founder and the report's author, "Evidence-based medicine [EBM] is an attack on the patient-doctor relationship. EBM is not individualized care. It is group-think medicine. . .Control over medical decisions is being shifted from doctors to data crunchers; from professionals at the bedside to bureaucrats in big offices. . .The public should not be fooled by the nifty-sounding names. Evidence-based medicine is managed care masquerading as science." Another linchpin in the plans to nationalize health care entails massive electronic databasing of everyone's private medical information, from cradle to grave. On June 8, the House Energy and Commerce Subcommittee on Health approved by voice vote a bill (HR 4157) that would further promote the use of health care information technology. This bill follows on a Senate version, S 1418, the Wired for Health Care Quality Act, introduced last year. S 1418 “Establishes the Office of the National Coordinator of Health Information Technology to develop a nationwide interoperable health information technology infrastructure.” On November 18, 2005, S 1418 was approved by the U.S. Senate by unanimous consent. Among other things, the Wired for Health Care Quality Act expands funding for the Office of the National Coordinator of Health Information Technology (ONCHIT). ONCHIT was apparently established by an Executive Order of President George W. Bush on April 27, 2004. The federal government's embrace, and increased spending in recent years in support, of “HIT,” as it's called, have raised concerns among many privacy experts. Yet, almost all politicians, medical bureaucrats, trade associations, media, and other players support, and seem to be in awe of, the hyped up promises made on behalf of health IT. Public opinion reports, such as one by the Markle Foundation in October 2005, have been put forward claiming that “more than seven out of ten Americans support the creation of a nationwide health information exchange or network for doctors and patients.” Additional concerns should arise from the news announced by the Food and Drug Administration (FDA) on June 9. Starting in December 2006, rules will go into effect requiring the electronic tracking of every prescription drug “from factory floor to pharmacy door,” as the New York Times described it. This Orwellian monitoring is now possible because of “the development of electronic tracking [RFID] technology, particularly digital identification tags that can be scanned with radio waves. Such tags have become small enough to embed in the labels of individual drug bottles and packages. The tags can store more information than bar codes and can be scanned from farther away. And in contrast to bar codes, bunches of them can be scanned simultaneously.” In all of the areas mentioned in this article it is reasonable to assume that there are agendas in addition to or other than the stated ones at play, coming together in order to accelerate the momentum towards medically testing everyone, electronically monitoring everyone's health, creating electronic databases of everyone's most personal health records in permanent files controlled by governments, and ultimately narrowing treatment options to ones approved by the government. Such plans are always proposed by public officials and representatives of the medical Establishment supposedly with the best of intentions, as the stakeholders insist ad nauseam that their machinations are intended only to improve public health and efficiency. It is worth recalling that Supreme Court Justice Louis Brandeis wrote in a dissenting opinion in Olmstead v. U.S., 277 US 438, 479 (1927), "Experience should teach us to be most on our guard to protect liberty when the Government's purposes are beneficient....The greatest dangers to liberty lurk in insidious encroachment by men of zeal, well-meaning but without understanding." Return to
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