When Gov. Sarah Palin wrote about “death panels,” she was widely ridiculed. It was actually voted the “Biggest Lie of 2009.”
Here’s a portion of what she wrote:
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.
Clearly Palin was concerned that the passage of health care reform would lead to a group of government bureaucrats choosing what medicines a person can have to save their life.
Kind of outlandish, huh?
Just days after the recess appointment of Donald Berwick, the controversial new head of Medicare and Medicaid, the Ovarian Cancer National Alliance posted the following grim news: for the first time in history, an FDA-approved anti-cancer therapy may not be covered by Medicare.
Provenge, a vaccine to treat the recurrence of prostate cancer, has been approved by the Food and Drug Administration (FDA)… Medicare usually covers the cost of FDA-approved anti-cancer therapies. However, the Centers for Medicare and Medicaid Services (CMS) is still reviewing whether it will cover Provenge, and at what rate.
The CMS statute states that Medicare must cover therapies that are reasonable and necessary, while the FDA is instructed to approve drugs that are safe and effective. Because of the conflicting Federal coverage and approval requirements, there are some non-FDA approved drugs (called off-label drugs) that are paid for by CMS. However, with respect to Provenge, it appears that CMS is arguing that while the treatment is safe and effective, it may not be reasonable and necessary. For the first time, an FDA approved anti-cancer therapy may not be covered by Medicare.
A life-saving cancer treatment “may not be reasonable and necessary”? Gee, that kind of decision-making by an unelected federal bureaucracy certainly sounds like a death panel to me.
Donald Berwick is the man who just thought Great Britain’s National Health Service was the bee’s knees. He’s a big fan, remember? Rationing care, including medication for cancer patients, is something the NHS has made an art form of.
Well, imitation is the most sincere form of flattery. It seems Berwick really wants to flatter the NHS.
Verum Serum has been coresponding with CMS. Here’s one of their updates:
Update 3 (11:30AM PST): Okay, I think we’re finally getting to some clarity on this. Here is CMS’ most recent response:
We could do one of three things: a decision to cover, means all contractors must cover it; a non-cover decision would mean that no contractor could cover it. Or we could take no action and leave it at contractor discretion. You must understand that this is similar to rulemaking, and once we open a case, we can’t comment on it until it’s finished. I’ll ask if we’ve ever non-covered a drug.
So, just as OCNA described it, CMS is making a national decision about Provenge. That decision won’t be made until next June. A proposal is due in March of 2011. But the point is that CMS has put the question of whether to cover an FDA approved drug on the table and one possible outcome is a decision not to cover it, i.e. not to reimburse under Medicare for its use. If that were to happen and given the cost of the treatment, it is very unlikely that any patient relying on Medicare would receive it. That much is settled.
The very idea that somewhere in Washington, a group of government employees is gathering to decide whether the elderly Medicare patients in America will be covered, despite the fact they have contributed to the program via taxes for the majority of their life, is a grim foreshadowing of what is to come.
