Obamacare: Who is behind the healthcare crapshoot curtain?

As I have explained before, Obamacare’s grand scheme is to reduce medical care costs by demanding that insurance companies only pay for those treatments, drugs and devices which are found to work in a majority of cases. For those outliers who need highly-customized care, you are pretty much on your own.

Here is an easy-to-read chart to help you understand the process of delivering healthcare based on statistical norms. As you can plainly see, this is a normal bell curve that may be used to establish care parameters.

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PCORI: A private non-profit corporation that is destined to join the other democrat-controlled bloated bureaucracies …

Gene L. Dodaro, Comptroller General of the United States and head of the U.S. Government Accountability Office (GAO), notwithstanding the obvious conflict of interest between the two positions, has issued a press release regarding the “Methodology Committee” of PCORI (Patient-Centered Outcomes Research Institute) which is organized not as a government agency, but as a private non-profit corporation.

The “methodology” committee’s task …

“The Methodology Committee has the responsibility of helping PCORI develop and update methodological standards and guidance for comparative clinical effectiveness research. The men and women named today bring impressive credentials and experience to this important task,” Dodaro said.

“The Patient Protection and Affordable Care Act authorized PCORI as a non-profit corporation to assist patients, clinicians, purchasers, and policymakers in making informed health decisions by providing quality, relevant evidence on how best to prevent, diagnose, treat, and monitor diseases and other health conditions.”

Of course, “best” does not always mean cost-effective nor what is “best” for individuals as opposed to the collective population.

So who is behind the curtain …

The members appointed to the Methodology Committee are:

• Naomi Aronson, PhD, Executive Director, Blue Cross and Blue Shield Association Technology Evaluation Center.

• Ethan Basch, MD, MSc, medical oncologist and health services researcher, Department of Medicine and Department of Epidemiology, Memorial Sloan-Kettering Cancer Center.

• Alfred Berg, MD, MPH, Professor, Department of Family Medicine, University of Washington.

• David Flum, MD, MPH, Professor, Department of Surgery and Adjunct Professor, Department of Health Services, University of Washington Schools of Medicine and Public Health; Attending physician, General Surgery, University of Washington Medical Center.

• Sherine Gabriel, MD, MSc, Professor of Medicine and of Epidemiology, and the William J. and Charles H. Mayo Professor, Mayo Clinic.

• Steven Goodman, MD, PhD, Professor of Oncology, of Pediatrics, of Epidemiology and of Biostatistics, Johns Hopkins School of Medicine and Bloomberg School of Public Health.

• Mark Helfand, MD, MS, MPH, Professor of Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University; Staff physician, Portland VA Medical Center.

• John Ioannidis, MD, DSc, the C.F. Rehnborg Professor in Disease Prevention, Professor of Medicine and Director, Stanford Prevention Research Center, Stanford University School of Medicine.

• David Meltzer, MD, PhD, Director, Center for Health and the Social Sciences, Chief of the Section of Hospital Medicine, and Associate Professor, Department of Medicine, Department of Economics, and Graduate School of Public Policy Studies, University of Chicago.

• Brian Mittman, PhD, Director, VA Center for Implementation Practice and Research Support, Department of Veterans Affairs Greater Los Angeles Healthcare System.

• Robin Newhouse, PhD, RN, Assistant Dean, Doctor of Nursing Practice Program and Associate Professor, Organizational Systems and Adult Health, University of Maryland School of Nursing.

• Sharon-Lise Normand, MSc, PhD, Professor of Health Care Policy, Harvard Medical School and Professor of Biostatistics, Harvard School of Public Health.

• Sebastian Schneeweiss, MD, ScD, Associate Professor, Department of Medicine, Harvard Medical School and Associate Professor, Department of Epidemiology, Harvard School of Public Health; Vice Chief and Director, Drug Evaluation and Outcomes Research, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital.

• Mary Tinetti, MD, Professor of Medicine, Epidemiology, and Public Health, Division of Geriatrics, Yale University School of Medicine; Director, Program on Aging, Yale University School of Medicine.

• Clyde Yancy, MD, MSc, Chief, Cardiology, Northwestern University Feinberg School of Medicine; Associate Director, The Bluhm Cardiovascular Institute, Northwestern Memorial Hospital.

Remember this is only the prestigious leadership of the committee, the actual work will be conducted by staffers who will rely heavily on research conducted by others and possibly “outsourced” research grants to some of the very organizations that are represented on the board. In fact, no one can determine the actual amount of committee work that will be performed by these “busy” professionals.

What the heck is “epidemiology?”

Since the word is repeatedly found in the job titles of the committee members, I think it would be helpful to understand that that the field represents the intersection of medicine and statistics for the purposes of setting social policy.

Epidemiology is considered the basic science of public health, and with good reason.

Epidemiology is:

a) a quantitative basic science built on a working knowledge of probability, statistics, and sound research methods;

b) a method of causal reasoning based on developing and testing hypotheses pertaining to occurrence and prevention of morbidity and mortality; and

c) a tool for public health action to promote and protect the public’s health based on science,
causal reasoning, and a dose of practical common sense <Source: CDC)

However, the major flaws of “epidemiology” lie in the selection of subjects to be studied, the inherent bias of the researchers proposing and conducting the study and the inherent flaw of confusing correlation with causation. But the greatest flaw is simply that the science intersects with the corrupting influence of politics and the need to produce solutions which are based on – not science – but political calculations of the administration in power. An administration which controls both the funding and staffing of a research organization’s leadership. And as we have seen in the global warming scheme, previously honorable, well-credentialed, scientists at prestigious institutions can be corrupted by politics and the quest for personal fame and fortune.

Dealing with “conflicts of interest …”

In addition to the natural conflicts of interest arising from political interests controlling the committee, it is somewhat interesting to see that the Administration has noted that there will be conflicts of interest and plans to deal with them the same way physicians and scientists deal with research sponsored by the pharmaceutical industry. By disclosure, rather than prohibiting such conflicts. After all, who wants to limit the flow of money in the system?

“The Comptroller General is required to disclose any conflicts of interest on GAO’s website.”

Some of the already listed conflicts look like:

  • Received consulting fees between 5,000 and $15,000 from: Aspen BioPharma, Inc., as a member of its Medical Advisory Board.
  • Spouse is employed by Group Health Cooperative, Seattle, WA.
  • Spouse receives royalties of more than $50,000 from Hoffman-LaRoche LTD, Roche-Diagnostics.
  • Received consulting fees of between $15,001 and $50,000 from: Blue Cross-Blue Shield Association, as a Scientific Advisor to its Medical Advisory Panel, Technical Assessment Program
  • Investments between $10,001 and $50,000 in: Aetna Inc.
  • Also employed by: Sepulveda Research Corporation
  • Received consulting fees between $5000 and $15,000 from: Washington University in St. Louis; University of California at Los Angeles; RAND Corporation; Institute for Healthcare Improvement; University of Iowa (estimated amount in 2011)
  • Received consulting fees between $15,001 and $50,000 from Westat, Inc.

To be fair, we are not saying that these researchers are already tainted, but we are saying that there is always the possibility that these researchers will promote that which they know the best or advocate for outcomes that will benefit certain industries – not unlike highly-paid lobbyists are employed to influence political decisions.

Bottom line …

Obamacare is more about politics than it is providing healthcare services to American citizens.

Proof of this assertion can be found in the fact that Medicare and Medicaid have been politically manipulated by industry lobbyists for years and that the waste, fraud and corruption which every party condemns continue to rise unabated by government action. Not to mention all of the special deals which were cut by Congress to secure the votes of legislators or the special deals allowing certain states and organizations for legislators to opt-out of the legislation’s provisions – or the original deals cut with the pharmaceutical industry, the insurance industry, the medical equipment suppliers and others – to moderate their opposition to Obamacare.

Talk about a conflict of interests? Not to mention the machinations of the Administration and Congress in the blatantly dishonest method of costing care under the 2000+ page bill which no one read and could understand – presented with hardly enough time to even begin reading the legislation or understanding that this was a 2000+ page outline of bureaus, panels and commissions to be created. And not to mention the tremendous discretionary powers given to the Administration through the politically-appointed Secretary of Heath and Human Services.

One should also consider the Marxist influence on the democrat party which developed this healthcare plan with the assistance of far-left foundations. There are inherent conflicts of interests in pursuing a political ideology which is based on collectivism rather than individualism and an ideology which views the population as units to be managed and controlled.

I would also like to mention that a decline in healthcare in America would also financially benefit the government through reduced costs in the last stages of a senior’s life, where much of the medical intervention funds are actually spent.

It is my opinion that Obamacare presents a clear and present danger to American citizens. The simple fact that in the human population, there are outliers (people outside the norms) who may be condemned to suffering or death based on providing services to the greatest number of people. Not to mention the necessity for the denial, delay and death-enhancing alternatives that are the natural consequence of a system forced to accommodate millions of new patients without a corresponding increase in facilities, physicians, diagnostic equipment and medical devices.

Why would any rational person, a believer in science, statistics and the delivery of decent healthcare destroy a system which serves 85% of the American population in order to add coverage for an additional 12% – and most of them illegal aliens?

Why would any freedom-loving American cede control over every aspect of their lives by allowing the government to link almost any facet of living, including finances, employment, nutrition, education and other critical areas to the delivery of healthcare?

But the real bottom line, as I have said on numerous occasions is …


-- steve

“Nullius in verba.”-- take nobody's word for it!

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