Jun 11 2009
‘All of us want reform. But the government-run plan that some are proposing here in the U.S. isn’t the kind of change Americans are looking for. We should learn a lesson from the problems that we’ve seen in countries like Great Britain and New Zealand’
WASHINGTON, D.C. - U.S. Senate Republican Leader Mitch McConnell made the following remarks on the Senate floor Thursday regarding the importance of getting it right on health care reform:
“The American people are frustrated with the U.S. health care system. But they’re also increasingly concerned about some of the proposals coming from Washington. And now the alarms are beginning to sound. As reported in today’s New York Times, the nation’s doctors are strongly opposed to the so-called government plan that appears to be gaining steam here in Washington. The American Medical Association says a government plan threatens to restrict patient choice by putting out of business existing health plans that cover nearly 70 percent of Americans.
“One estimate suggests that 119 million Americans could lose the private coverage they have as a consequence of the government plan. Moreover, the AMA, in its statement from yesterday, notes that ‘the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.’
“Republicans and Democrats alike agree that health care reform is needed in this country. But a government plan is not the kind of reform the American people want. They want real reform for a system that’s in serious need of it. Unfortunately, what some in Washington are proposing instead is the illusion of a reform that will replace what’s good about health care in America with something that’s far worse.
“Instead of making health care more affordable and accessible, these proposals could make treatments and procedures that everyday Americans currently take for granted less accessible or even impossible to obtain — even as these proposals would add to the colossal and unsustainable debt that already burdens the federal government.
“I have spoken repeatedly here on the Senate floor about the dangers of a government-run health plan. By drawing on the experience of countries that have already adopted these government-run systems, I’ve pointed out the serious problems government-run health care creates for millions around the world. I’ve noted that a common defect of these government-run plans is that they deny, delay, and ration health care. And I’ve noted that the primary culprit in almost every case is the so-called government board that these countries have established to decide which treatments and medicines patients in these countries can and cannot have. This morning I’d like to focus again on these so-called government boards, so people have an idea of what they could expect from a government-run plan here in the U.S.
“Britain’s government board, the National Institute for Health and Clinical Excellence, or NICE, is responsible for setting guidelines on the use of drugs and treatments for patients in that country. The government bureaucrats at this agency are supposed to weigh the effectiveness of a medicine or a treatment against its cost to the government. If the government thinks that a drug is too expensive, it can refuse to make it available to patients, regardless of any potential benefits.
“Last summer, the board in Great Britain denied patients in that country access to four kidney cancer drugs that have the potential to extend life. Here’s the chilling explanation it gave to justify the move: Quote: ‘Although these treatments are clinically effective, regrettably the cost … is such that they are not a cost-effective use of … resources.’ After a public outcry, NICE reversed its position on one of the drugs, but reaffirmed its ban on the other three.
“In New Zealand, a government board known as Pharmac reviews potential drugs and treatments and decides whether or not they should be prescribed to patients in that country. Pharmac says its goal is to use its, quote, ‘expertise’ to ‘help … decide which new hospital medicines are cost-effective.’ And just like the government board in Great Britain, if Pharmac doesn’t think a drug’s cost justifies its benefits, it can refuse to make it available to patients or doctors who want it.
“One drug that Pharmac didn’t think was worth the cost was Herceptin, which had proven to be effective in fighting breast cancer. Although Pharmac began covering the drug for advanced breast cancer in 2002, it refused to fund the drug for early-stage breast cancer. After a public outcry and a reevaluation of the decision, Pharmac finally relented and decided to allow the drug for early stage breast cancer in 2007 — but only for a limited amount of treatments.
“These kinds of decisions about which drugs should and shouldn’t be covered are based on a method commonly known as Comparative Effectiveness.
“Comparative Effectiveness is not alien to the U.S. health care system. Indeed, the Stimulus Bill Congress passed earlier this year included significant funding to lay the groundwork for just this kind of research here in the U.S. And in my view, the more research we do on the effectiveness of drugs and treatments the better. Doctors should have as much good information as possible in dealing with their patients.
“What Americans strenuously oppose, however, is the government using this information to deny access to treatment or procedures that patients and doctors choose to pursue — just as government agencies like NICE and Pharmac do in Great Britain and New Zealand. Americans oppose this kind of government-mandated limitation on health care. They just won’t allow it.
“And that’s why my friend, Senator Kyl, will propose a bill that would prohibit the government from ever using comparative effectiveness in this way. It’s a wise bill, and it should be included as a part of any health reform we consider. Americans want their doctors to have clinical information on which treatments work best and which ones don’t. But government bureaucrats shouldn’t be able to use that information to determine what treatments Americans can or cannot get. That’s a decision we currently leave between a patient and his or her doctor. And that’s where it should remain.
“Americans want to see changes in the health care system. But they don’t want changes that deny, delay, or ration care. They want reforms that control costs even as they protect patients. They want us to discourage frivolous medical liability lawsuits that limit access to care in places like rural Kentucky; they want prevention and wellness programs that cut costs by helping people quit smoking, overcome obesity, and diagnose illnesses early; and they want us to address the needs of small businesses without imposing new mandates or taxes that kill jobs.
“All of us want reform. But the government-run plan that some are proposing here in the U.S. isn’t the kind of change Americans are looking for. We should learn a lesson from the problems that we’ve seen in countries like Great Britain and New Zealand. We should learn a lesson from the nightmares that so many people in these countries and their families have endured as a result of government-run health care and the bureaucratic government boards that almost always come with it.”