My opinion – 1hr is far too short of a forum for the most comprehensive legislation in half a century. Representative McNerney needs to spend A LOT of time listening to his constituents about this – hopefully in public.
I have tried calling and writing about the following, and asked to be heard on both forums. I got put on hold for both town halls and received form letters (that don’t answer my questions). Here are my questions. I hope that our representative can answer them.
"To Representative Jerry McNerney
This is the most important issue in 50 years and two teleconferences are not enough to address these issues. I hope you (Congressman McNerney) will take the time to meet us in person.
My primary concern is the considerations regarding the level of health care services provided and the costs of those concerns and how those concerns may be addressed without rationing.
For example, you, the President, Speaker Pelosi, and other Democrats continually talk about how we will increase care and reduce costs. You specifically cite attention to preventative medicine as a mechinism to reduce those costs. I contend that those assertions are misinformed, at best, and misleading, at worst. In either case the people proposing this massive overhaul are either ignorant or dishonest, and the American people do not trust you to make these drastic steps that, literally, affect out lives.
The President often speaks about increasing spending in mammography and other early detection techniques to save money by finding cancers early. Early detection does save lives, but it does not save money. Early detection of breast cancer is what I do for a living, so I understand this field.
Mammography does find cancers earlier and it does reduce breast cancer mortality by 30% (about 17,000 lives saved in the US each year). 37 million women get mammograms each year, however, at a cost of $150 each – or about $5.5 billion per year. If those 17,000 women whose lives are saved by mammography each year were allowed to be treated through death, the cost would be about $3 billion. We could save $2.5 billion by abandoning mammography and allowing these women to die. I believe that is an immoral choice – but it is the most cost effective.
This is why Europe and Canada ration mammography. They don’t offer it to women under 50 and they only offer it every other year. We offer it to women 40 and older and offer it every year now.
Advances in healthcare are expenseive.
40 years ago there were no hip and knee transplants, there were no cardiac stents, and cardiac bypasses were just past the experimental procedure state. Today these procedures have extended life – and they’ve improved the quality of life – but they are expensive. The cost of those procedures alone is over $50B. Those are primarily Medicare procedures and that’s more than 10% of the Medicare budget. In addition, dropping dead of a heart attack is cheap – but treating the cancers that are almost an inevitable result of living longer are expensive. It is much more expensive to treat someone who has cancer than it is to treat someone who drops dead of a heart attack.
If saving money is the goal of healthcare reform then you can achieve that by reducing care. Our longer, higher quality lives are the result of additional treatments and those treatments cost money.
That’s why we’re afraid that the end result of this legislation will be rationing and that’s why we don’t trust the President, or you. The President has stated publicly, specifically in the New York Times Magazine article in May of this year that we really need to reconsider the healthcare expenditures we provide to the chronically ill and old. He says that we will need to depend on “independent groups of doctors, scientists, and ethicists” – not patients – to provide guidance.
The healthcare bill also talks about similar groups of “stakeholders” to provide guidance for end-of-life care.
I’ve read this bill it doesn’t appear to specifically call for rationing, but with requirements of these committees of “stakeholders” to counsel folks on end-of-life care it appears to be able to provide a mechanism for rationing (pages 425 to 433 of HR3200).
You want us to trust that the Federal government will not take that power. Most of us do not trust the Federal government to refrain from taking whatever power it can – particularly since the President’s own words indicate that he believes that a form of rationing will be necessary."