Thursday, July 23, 2009

George Orwell and healthcare reform

For someone who spent her childhood behind the iron curtain, George Orwell's novels were at once prophetic and horrifying. Reading about "spontaneous demonstrations" in Animal Farm evoked images of my own participation in the May day parades, designed less to show solidarity with workers of other nations than to show off the contrived unity and the military might of the former USSR. To me, the double-speak captured by Orwell was chilling.

With an equally chilling Orwellian turn of phrase, in her op-ed piece in today's Wall Street Journal, Betsy McCaughey contributed fuel to the conservative hysteria over the proposed healthcare reforms. Her comments were beautifully deconstructed by SHADOWFAX on his excellent blog Movin' Meat. Ms. McCaughey currently serves as the chairperson of the Committee to Reduce Infection Death, whose homepage incidentally sports a familiarly eerie Bushism "Save lives just by searching & shopping". She fanned the flames of status quo by asserting that the legislation as written will ration healthcare delivery to our seniors practically to the point of advocating convenience euthanasia, an abhorrent practice by some veterinarians for their clients whose dogs may have inconvenienced them by peeing on their favorite rug. With a single swing of her literary sledgehammer she tried to crush AARP's support for the much needed reform.

No argument against the reform rang more hollow than her disapproval of funding for comparative effectiveness research (CER) in the recent stimulus package, intended to demystify the value propositions of healthcare interventions. The allocation of $1.1 billion to CER is long overdue, as we have been unable to say "no" to reimbursing anything from a me-three anti-hypertensive to an MRI for low back pain to a bypass operation for a 95-year-old with limited quality of life. Equating this initiative to rationing is true double-speak that can succeed in creating panic only under the assumption that we are, well, stupid.

If Medicare is to survive long enough for my peers to benefit from it, it needs to undergo severe liposuction, with CER as the rational framework. Let's stop wasting time, breath and trees on these unimaginative doomsday scenarios and move on with the work of fixing this broken system. Still, if this Napoleon-like discourse is the lynchpin of the conservative strategy, don't let me stop them from discrediting themselves.

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