Several months ago I began experiencing problems walking. I was born with deformed bones in my left foot, and the pressure from walking on this abnormal foot structure for more than 30 years has begun to take its toll. I visited several podiatric and orthopedic specialists to evaluate my options. Noninvasive methods such as orthotics and therapy helped, but it became apparent to me that they weren’t really solving the problem; they were just delaying the inevitable.
So I consulted with a surgeon, and he arrived at a plan of action—fusions, grafts, and a tendon lengthening—which should significantly alleviate my pain and improve my gait. Feeling comfortable with the surgeon’s level of expertise and with his recommended treatment plan, I scheduled surgery for a few weeks from now.
However, the recent debate over the Independent Payment Advisory Board (IPAB)—Obamacare’s body of unelected bureaucrats who will control Medicare spending—has prompted me to reconsider my decision.
After all, who am I to decide how my own health care should be handled?
Leave it to the Experts
The Nobel prize-winning economist Paul Krugman has taught me “patients are not consumers” and “making [health care] decisions intelligently requires a vast amount of specialized knowledge”. The Washington Post’s Ezra Klein has taught me “consumer-directed health care is a silly idea” because “patients are not qualified to evaluate good care.” And CMS Administrator Donald Berwick has said, “I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.”
These statements have left me in a serious conundrum, forcing me to reconsider my thinking. After all, I’m not an expert on health care—I’m not even close. I don’t have a Ph.D. in economics, which Health and Human Services Secretary Kathleen Sebelius recently claimed qualifies individuals as “experts” in how to run a health care system.
I do, however, now recognize that I am not only clearly incapable of making my own health care choices, but also that my health—and our entire country—would improve if we leave those choices to “experts” who are my intellectual superiors.
Trust Enlightened Bureaucrats
All I need now is to find a suitable “expert” to tell me whether I should have the surgery or take the painkiller. Therein lies my open request to IPAB’s defenders, to provide me with the enlightened knowledge of my own medical condition that I so clearly lack:
- Former OMB director Peter Orszag, who supports IPAB as a way “to improve Medicare’s cost-effectiveness,” can tell me whether my surgery will cost too much;
- White House health advisor Zeke Emanuel can tell me where my procedure fits on his chart for the allocation of scarce medical resources; and
- Dr. Berwick can tell me if I’m one of those cases where “Most people who have serious pain do not need advanced methods; they just need the morphine and counseling that have been available for centuries.”
I do hope one of these individuals—or other political commentators who have supported IPAB in recent weeks—can tell me how I should proceed. After all, I now realize my surgeon could be recommending an operation just for the reimbursement check, because most medical professionals base their decision-making processes on whether they will obtain a $50,000 payday.
Lack of Responsibility
There is a catch, however: Although I will defer my own opinion to those of the “experts,” I do expect that any individual who passes judgment on my case will assume full financial and legal liability for same.
That may be a problem for some of IPAB’s defenders. After all, Section 3403 of the statute exempts the IPAB and its members from any legal liability associated with its decisions.
And therein lies the point of this proposal, and this story. If the IPAB’s defenders—and its so-called “experts”—aren’t willing to put their own money where their mouths are, then how good will this board of unaccountable bureaucrats be?
Chris Jacobs ([email protected]) is a health policy analyst for the Senate Republican Policy Committee. This column is reprinted from The Daily Caller with permission.