The Food and Drug Administration (FDA) is moving to “de-label” Avastin, the late-stage cancer drug for breast cancer patients. If successful, the FDA would allow Medicare and private insurance to deny coverage for the drug – even for patients who have relied on the drug to live.

The FDA has denied that the cost of the drug played a role in their decision but the evidence is mounting that is not the case.  During initial consideration of the decision an FDA advisor specifically cited the cost of the drug as the reason for revocation.  The drug costs $80,000 a year and allowing Medicare to deny coverage for the cost would “reduce the cost of health care,” as President Obama has demanded.

The FDA and their supporters deny cost is the basis of the decision.  George Soros’ Media Matters denounced the rationing claim proclaiming that the drug does not “does not significantly prolong life.”

Significantly? Is six months, the average time an Avastin patient gets in extended life, “significant”?  Is one year?  What about the cases of the “super responders,” the women like Erin Howarth, who have taken Avastin for years and credit the drug for saving their life?

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With little fanfare, Rationer-in-Chief Donald Berwick, President Obama’s choice to head the Centers for Medicare and Medicaid Services, appeared before the House Ways and Means Committee and did his best impression of Gumby – twisting and turning his support for rationing health care.

Berwick has championed the British health care system for years proclaiming his outright support of rationing. In 2009, Berwick said, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.” In a 2008 speech, Berwick proclaimed, “I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country.” Of course, the British system openly rations care for the sick and the elderly.

But Berwick ran from those statements like a scalded dog before House members who asked pointed questions about his support for rationing care. When Rep. Tom Price (R-Ga.) asked him whether he supports healthcare rationing, Berwick said, “I abhor rationing.” At another point he said that he spent his whole life fighting rationing, The Hill reports.

Chairman Dave Camp (R-Mich.) asked him whether he was still “in love” with the British healthcare system, Berwick’s response: “There are strengths and weaknesses in every healthcare system in the world. The American healthcare system needs an American solution.”

For fear of stating the obvious, it is clear Berwick was not honest in his testimony.

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From the Associated Press:

Federal health authorities are recommending the blockbuster drug Avastin no longer be used to treat breast cancer, saying recent studies failed to show the drug’s original promise to help slow the disease.

The Food and Drug Administration’s decision is supported by many cancer experts but is sure to draw resistance from cancer patients and some doctors who fiercely defend the drug and say it should remain available.

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Obama Medicare Head Bringing UK Rationing Board to US?

Medicare Head Donald Berwick will testify in front of the Senate Finance Committee Wednesday for the first time since President Obama used a recess appointment to put him into place. He’ll be facing down a host of Republicans who objected to his nomination on the grounds that he’s in love with wealth redistribution and Britains National Health Service.

Sens. Pat Roberts (Kan.), Mitch McConnell (Ky.) and John Barrasso (Wyo.) joined forces on the Senate floor shortly after the last vote of the day and urged members to review Berwick’s record before voting on his confirmation. They accused Berwick of promoting health care rationing, especially for older people, and particularly criticized his endorsement of Great Britain’s National Healthcare System (NHS). “Dr. Berwick is a huge fan of … the NHS, a system that relies on rationing health care to hold down costs,” Roberts said. “Dr. Berwick has said, ‘I am a romantic about the NHS; I love it,’ and ‘the NHS is not just a national treasure, it is a global treasure.’”

In case Americans are unaware, the NHS has a terrifyingly active healthcare rationing panel. Originally put in place to reduce healthcare costs, root out bad doctors and useless treatments and ensure that healthcare practices were at their absolute best. Over time, NICE has taken to “reducing costs”by limiting the kinds of treatments British patients are allowed to receive through government healthcare. The Wall Street Journal warned Americans last July about NICE and cost-cutting panels. They cited NICE’s rulings against providing lifesaving breast and stomach cancer drugs, blocking or restricting access to drugs to treat macular degeneration, kidney disease, rheumatoid arthritis, multiple sclerosis and myloma, and NICE’s restrictions on fertility treatments, certain surgical procedures and cervical cancer screenings, all in the name of saving money.

One of the questions Berwick will face will likely be on the subject of IPAB – the Independent Payment Advisory Board – a panel made up of fifteen unelected bureaucrats who will be charged with making drastic cuts to medicare on a yearly basis, likely limiting patient choice for Medicare recipients. The panel’s decisions are unappealable and can only be overturned by a supermajority vote in Congress. Berwick will have to explain how IPAB – termed by Sen. Tom Coburn as a “a government command-and-control bureaucracy that will dictate payment decisions and interfere with the best judgment of physicians and families” – is necessary and beneficial to Medicare patients.

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Dr. Donald Berwick, a leading proponent of rationing of medical care in the United States and a supporter of the British health care system, is prepared to testify before Congress for the first time since he recess appointment to head the Centers for Medicare and Medicare Services.

Republicans have a constitutional obligation to get Berwick’s views on the record and appear ready to do so.  Politico reports that Republicans will focus their questioning on five areas including his professed “love” of the British government-run health care system.  Berwick has called the National Health Service – with its rationing of treatment and care – as “one of the greatest health care institutions in human history” and “a global treasure,” once saying that it set an “example” for the United States to follow.

Berwick’s support for rationing lead President Obama to bypass the Senate confirmation process to appoint Berwick to his post.

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One of the chief responsibilities of the Congress is the provide oversight of the executive branch — a responsibility that the Democrat Congress has punted. The president nominated Donald Berwick to head the Centers of Medicare and Medicaid, a proponent of rationing for the poor and elderly. Not only did the Congress not hold a single hearing about Berwick’s support for a government-run health care system, they never voted on his nomination. Berwick now heads an agency bigger than the Department of Defense without so much as a question being asked about his qualifications and extreme views.

Berkwick’s support for the imposition of a British-style health care system complete with its rationing regime is clear. “The decision is not whether or not we will ration care–the decision is whether we will ration with our eyes open,” Berwick said in a June 2009 interview with Biotechnology Healthcare.

In an interview last June, Dr. Berwick said, “NICE is extremely effective and a conscientious, valuable, and — importantly — knowledge-building system.” He added that NICE has “developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn.” Moments later, the interviewer asked, “So you are saying that the federal CER [Comparative Effectiveness Research] agency should get involved in cost determinations?” Berwick replied, “You can say, ‘Well, we shouldn’t even look.’ But that would be irrational. The social budget is limited.” NICE is the government agency in Britain that rations care on a daily basis. Professor Mike Rawlins, the chairman the British National Institute for Health and Clinical Excellence (NICE) who said: “The question is not whether care is rationed but how.”

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In response the sharp rebuke of Obamacare sent by voters in Missouri, Senator Harry Reid says that voters in Missouri just don’t know enough about the new law yet and when they do, they will change their minds. Well Senator, Missouri is after all the Show Me State and apparently Missourians don’t like what they have seen so far.

The simple truth is: You can’t get something for nothing and someone has the pay the bill.  Nothing in Obamacare creates more health care. It is merely injects government into the equation in order to take what we have currently and redistribute it.  So naturally, the government will need to find ways to cut costs.

Soon to be former director of the OMB, Peter Orzag believes that we can save money “…if costly new medical services were adopted more selectively in the future than they have been in the past, and if the diffusion of existing costly services was slowed. “

Well, how does the government go about doing that? How do they tell people that a life saving or life extending treatment exists, but it just costs too much so patients can’t have it?

Well, they don’t. They utilize control over the system to manipulate the availability of the treatment and then lead people to believe that it just doesn’t work. Problem solved.

We’ve already begun to see this operation in action with the FDA’s recent attempts to de-label the cancer drug Avastin for use with Stage 4 breast cancer patients.

The FDA was created and designed to protect citizens from products that are inherently unsafe or that make claims of effectiveness that cannot be substantiated.  There is no authority to consider drug pricing when evaluating a drug.

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The ink is not yet dry on the Obama Health Care takeover and rationing advocate Donald Berkwick has yet to have his desk moved into the Medicare offices, and the Administration is already attempting to limit life-extending drugs for cancer patients.

This is the first shot in the health care revolution.

In September, the Food and Drug Administration will try to take the anti-cancer drug Avastin “off-label.”  Avastin is a Stage 4 drug used to battle breast cancer.  Avastin is not a cure but has been shown to stop the growth of cancer for an average of five months — meaning some late stage breast cancer victims live beyond five months.

But late stage breast cancer patients do not fit into the cost-benefit analysis of the Obama Administration.  We told America rationing would happen if the health care takeover bill passed and in September, women with breast cancer will be its first victims.

Avastin is the first medicine to fight cancer by blocking the growth of blood vessels that feed tumors.  While Avastin is expensive and may not be the miracle drug some anticipated for breast cancer (it is for other types of cancer) from the success of the early trials, the overwhelming majority of breast cancer specialists believe the drug can be effective and useful in certain patients

If the FDA takes Avastin off label it will effectively deny all but the richest Americans access to the drug. Once a drug is off label, most insurance and Medicare will no longer cover the cost of the treatment. So even if a patient meets the criteria of one who might respond positively to Avastin once it is taken off label it is highly unlikely that patient will have access to the drug unless they have the money to pay for it outright.

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It was an article of faith among Obamacare supporters that worry over so-called death panels was simply a cynical ploy by conservative leaders to scare the peasants. Blatant fearmongering, they claimed. Now it’s looking more and more like a valid concern.  Writing at the Daily Caller, Michael Tanner of the Cato Institute highlights quotes from Dr. Donald Berwick, President Obama’s nominee to be director of the Center for Medicare and Medicaid Services, which suggest that death panels might be on his wish-list.

“I am romantic about the National Health Service. I love it,” he has said about the British health care system.  His favorite part of British health care seems to be its rationing arm, the National Institute for Clinical Effectiveness (NICE).  NICE is responsible for determining whether or not the life-extending benefits a patient receives are worth the cost to the government.  Dr. Berwick calls this institution a “global treasure.”

How much is a human life worth? About £30,000 per year, according to NICE.  Anything more than $44,000 per year of extended life, and NICE is likely to deny treatment.  Important drugs that prolong the life of cancer patients, such as Lapatinib and Sutent, are not allowed.  Alzheimer’s drugs are also heavily restricted for those in the early stages of the disease despite the fact that the early stages are when treatment can provide the most benefit.  Originally pitched as nothing more than a board to promote “best practices,” NICE has become a rationing, death panel machine.

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In 2008 Patrick Swayze was treated with an advanced medical tool called a “CyberKnife.” It helped add months to his life as he tried to beat the cancer that was consuming him. But, Swayze wasn’t the only American with the good fortune to have this highly advanced medical technology available to him. In fact, there are 100 such machines across the United States. From California, to Minnesota, to Illinois and Washington D.C. Americans currently have the luxury of these wonderful new devices.

Sadly, Britons are not so lucky. There are two CyberKnife machines in the Britain, but they aren’t going to do anyone in the country’s socialist healthcare system any good because despite how successful these machines are British authorities won’t allow them to be used on patients.

Despite that the Mount Vernon cancer hospital in London is part of the National Health Services, despite that they spent £3m to purchase the machine, and quite despite the praise the machines receive in the U.S. and throughout the world, British NHS authorities won’t let NHS doctors use the machine on their patients.

Sadly, these heartless, uncaring socialist healthcare officials are uninterested in helping the estimated 10,000 British patients a year that could benefit from use of the CyberKnife. And why is this? Why, it’s because the treatments are expensive, of course.

You see money is far, far more important to Britain’s socialist healthcare system then patients.

As I said above, the U.S. is lucky to have many of these machines on our shores. In fact we have 100 of the 150 machines world-wide, all available for anyone that needs them. But this happy situation will not survive the implementation of America’s own socialist healthcare system when it institutes its rationing rules as the English have done. Sooner rather than later advanced tools like the CyberKnife will be eschewed as too expensive by Obamacre bean counters and such advanced technology will dwindle and wither away despite the lives it could save.

This is what is meant when it is said that Obamacare features death panels. After all, a socialist healthcare system that won’t pay for advanced technology because it’s just too darn expensive — just as is happening right now in England — is a defacto death panel.

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Oh, the President must be really desperate

After repeating for months that Republicans have no solutions when it comes to health care reform, he now wants to discuss the very ideas he denied existed and has invited Republican leaders to the White House to find a “bipartisan” health care solution. How gracious of him.

You’ll have to excuse us for questioning the sincerity of the President’s newfound desire to work together. As Chairman of the Republican Study Committee, virtually every week in 2009, we requested to meet with the President to discuss health care and other central issues. Each time, a polite “thank you” email from the White House was the extent of our bipartisan discussions.  It’s interesting that only now – once his big-government dream is on political life support – does the President see a use for Republicans.  And it appears that use may be more political than rooted in policy goals.

In fact, the President’s invite to Republicans has come pre-packaged with some pretty audacious spin. For starters, this week the President has aggressively tried to frame Republicans as the obstructers to health care passage, unwilling to participate in the process.  That’s a pretty tough sell for a President with a 77-seat majority in the House and 59 Democrat Senators in the other chamber. And before taking that line, the President might want to check with his partisan partner, Speaker Pelosi, who famously told House Democrats they would be shut out themselves if they attempted to work with Republicans on health care.

That brings us to the second, more laughable, new claim from the White House: that the bill already contains Republican ideas and concessions from Democrats. Right.

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Last week, Congressman Thad McCotter introduced a Bill HR 4500, The Freedom From Rationed Health Care Act, that invalidates a little known, hidden part of the Stimulus Bill. That hidden part of The Stimulus Bill created the rationing and enforcement boards.  Significantly, this “minor” fiscal trim makes the first part of ObamaCare null and void.

On November 7th, 2009, Speaker Pelosi marched to the podium and paraded her lap dogs to the microphone to proclaim “Victory” for herself, her Democratic House colleagues, and President Obama.  What about every other American? The “Victory” was the passage of the second part of ObamaCare, “The Health Care Bill.”  That’s right, the second part of ObamaCare is the 1,990 page bill that created 118 new boards, commissions, offices and bureaus. The same bill that will be paid for with (1)  $740 billion in tax increases,  (2)  a cut in Medicare to Seniors by $500 Billion, and (3)  a cost shift of $34 Billion to States in unfunded mandates.

This “Victory” was Pelosi’s and President Obama’s second victory on the health care front.  The first occurred under the cloak of darkness and obfuscation, in February 2009.  Hidden in The Stimulus Bill and passed into law were the ominous Obama, Pelosi, Reid rationing and enforcement health boards.

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My last article, Medicare is Already Rationing Care, focused on one small aspect of a much larger story, a story every American needs to know. The battle over the meaning of medicine began 2,500 years ago, not last spring.

In the late 1990’s I gave a lecture entitled “Post-Hippocratic Medicine in the Shadow of Nietzsche” in response to Peter Singer, the chair of bioethics at Princeton University. Singer had proposed we not consider humans “fully human” until they reached five weeks of age (after birth). During the first four weeks, he argued, we should allow the overt killing of infants with disabilities. This was “cost-effective.” It served the “greater good” by controlling the skyrocketing cost of healthcare.

For a decade I studied the question ”How did America reach a place in her history where we could seriously consider resurrecting the ancient practice of infanticide?” What I discovered changed my life.

For the past 2,500 years physicians served only one of two roles in Western culture. They either followed Hippocrates and served the wellbeing of their patients, or they followed Plato and served the greater welfare of the State. The philosophy of Peter Singer is not new—it has been with us for millennia. We once again stand at these same fated crossroads of Plato and Hippocrates as we debate the future of American healthcare.

Based on my study of history, philosophy, and current events, I feared we were rapidly returning to the world of Plato; a world where physicians worked at the behest of government, not solely for the patient. To help Americans understand what was about to transpire, I launched  Physicians for Reform in 2006.

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After reviewing the latest version of health care reform emanating from “the greatest deliberative body in the world”, The Senate, I was transported to Whoville, target of The Grinch…..from this point forward renamed America. It would appear that “Your mean ones,”   Mr., Ms and Mr. Grinch (Obama, Pelosi and Reid) have heard and learned nothing from the town hall meetings and from all of the e-mails, phone calls, faxes and letters from ALL of us Whos.

The latest version of the Grinches’ health care reform is a carbon copy of the rationing of health care that passed the House in November. The core and the heart is three sizes too small in both versions, and cuts costs by denying and rationing care, the most inhumane and unethical means of cutting costs. However, Washington’s Grinches have added a couple of “presents” to further harm all of us Whos.

The Grinches’ first “present” is to “allow” everyone in Medicare, or who will soon be in Medicare, to pay for a larger percentage of the costs of this beast. How special is that? The Grinches Obama, Pelosi and Reid have decided to cut Medicare by $500 Billion over ten years to pay for their reform package, even though millions more seniors will be on Medicare in ten years. Let’s look at the data that the Grinches refuse to acknowledge.

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Many advocates of health-care reform are admirers of Canada’s state-run, no-opt-out, single-payer system. Indeed, in 2003, President Barack Obama voiced enthusiasm for such a health-care program.

Proponents of Canadian-style health care should meet Cheryl Baxter, a Canadian citizen who waited years for hip-replacement surgery, only to be told that her operation would not happen any time soon. Instead of waiting, Baxter did what an increasing number of Canadians are doing: She flew to a clinic in the United States, paid out of pocket, and had a life-altering surgery in a matter of weeks rather than years.

Baxter’s experience doesn’t just throw damning light on Canadian health care. The sort of clinic she went to in Oklahoma suggests a different way of delivering health care in the United States, too: A simple fee-for-service
model in which providers openly advertise their prices, service, and reputation. Rather than a frustrating, complicated mess of intermediaries such as employers and insurance companies, U.S. health-care reformers should think about bringing medicine into line with the same dynamics that help deliver great service at great prices throughout most other parts of the economy.

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To achieve the goal of a universal, single-payer health system, the White House must secure the power it needs by amending the Social Security Act to transfer pivotal controls from Congress to the executive branch.  This transfer of power would ultimately give the President and the majority party, in this case the radical left Obama White House and Pelosi-Reid led progressive Democrats, the authority to frame and manipulate new policy, coverage options, and reimbursements, ultimately reshaping the future US health care system into a something unrecognizable in this country.

The deliberate setup for the White House power grab is built into the each of the health care bills and, if they fail, little-known twin bills called “MedPAC Reform of 2009” are waiting in the wings.  The bills, S.B. 1110 and H.R. 2718, craftily amend the Social Security Act and transfer the Medicare guideline and rule setting processes, from the legislative branch to the executive branch.  These bills offer cover to one another in case one doesn’t pass the House or Senate, respectively.  Remember, Democrats need to gain executive branch authority by amending the Social Security Act over Medicare regulations and physician fee schedules to transform the health care system in a single-payer, socialized system.

More importantly, Medicare’s regulations and physician fee schedules are the keystone to developing payer systems and reimbursement models across the entire health care industry.  And where Medicare goes, insurers follow.

To underscore the far-reaching power, a bulk of the states already reference or utilize the Medicare guidelines and fee schedules in determining policy, coverage, and payment, which impacts certain state-specific plans, including, but not limited to, self-funded plans, automobile insurance payers, and state workers’ compensation funds and plans – affecting even Big Labor.   For the executive branch to have such authority over Medicare regulations with little oversight is alarming.  This raises further issues of the powerful impact these federal mandates could potentially have on the states in stripping them of their own management of their respective insurance industries.

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If you would like a pre-Obama Care window into the possible future of American Health Care–if Democrats in Congress are successful in passing their sweeping health care legislation, you need look no further than government imposed rationing of heart disease prevention in this country. It is a travesty in the making and should demonstrate to everyone the capricious nature of government control over our health care.

I am writing of the Obama Administration’s – regulatory decision – to go ahead with a massive cut in Medicare payments to cardiologists. I emphasize that this is a regulatory decision because it was not made by the Congress legislatively (not that that would be ok) but, instead, it was made by the massive Health and Human Services Department of the US Government. Given the limited resources of the Medicare budget, in order to increase payments to general practitioners (in an effort to attract more such doctors – a good idea), bureaucrats needed to gore somebody’s ox and cardiologists were chosen (a horrible idea).

The decision to do so is astonishing.

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Last week,  the Federal Government Ivory Tower trumpeted important news.  One of its illustrious Task Forces has decided that women in their 40’s would be the first to experience “Medical Darwinism.”

The United States Preventive Services Task Force, comprised of 16 appointees, decreed that:

1.       Women in their 40’s no longer need routine yearly mammograms

2.       Women aged 50-74 are to have mammograms only every other year

3.       Self breast exams are no longer to be done at any age

Of note, this Task Force does NOT have even one member who is a cancer specialist or oncologist, let alone a breast cancer specialist. This panel based its recommendations NOT on comprehensive new clinical studies or research, but rather on computer projections of certain data points.  A review of previous recommendations by the same Federal Government reveals that these recommendations are diametrically at odds with recommendations made just six months ago. So, what changed in six months?

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It is crunch time tonight in Congress. Speaker Pelosi is moving towards a full floor vote on the Obama/Pelosi Health Care Plan up for a vote. At the time of publishing, votes are expected around 8 or 9pm EST. I received a call early this morning that my Orthopaedic Services were in demand.  Apparently, the Speaker, the President’s Chief of Staff Rahm Emmanuel and their staffs have been “breaking arms of anyone and everyone in sight that is on the fence about The Bill.”  These Enforcers have put Freedom, Liberty and constituent representation aside.

Do your congressmen/women have any idea what is in this 1990 page Bill, and what it means for each and every American?  So you do not have to count, it creates 118 new boards, commissions, offices and bureaus.  Supposedly, ALL of these new entities will be selflessly looking out for your “betterment.”  Somehow, ObamaCare needs all of these levels of review and personnel to provide better and more available healthcare to more Americans, and plans to work this miracle do this at a fraction of current costs.  (Oh, and they will eliminate Medicaid fraud in the meantime.)  This has little connection with reality.

There is another option.  A different reform package has been purposed by The GOP Leadership, and every member of the minority has signed on.  In fact, before this debate is over maybe a few “Blue Dog Democrats” (now with broken arms) will sign on as well. This reform package:

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Twenty-nine years ago I stood with my 150 classmates in Thorn Hall, at Northwestern University Medical School in Chicago, as Dean James Eckenhoff asked us to raise our right hands and repeat after him:    

I will apply measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.  In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice.

Those words, from The Hippocratic Oath written in 400 B.C., changed my life and the lives of the thousands of patients my classmates and I have touched over the past twenty-nine years. 

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