As taxpayers begin to grasp the sheer magnitude and the $787 billion price tag of H.R. 1, the American Recovery and Reinvestment Act of 2009, better known as the “stimulus,” more and more details are being exposed as policy makers have time to read and analyze the legislation.  There is one section of the bill that has little to do with stimulating the economy and everything to do with overseeing the kind of healthcare Americans will, or will not, receive in the future.

On page 63 of the conference report to H.R. 1, there is $1.1 billion for “comparative effectiveness research.”  The legislative text seems innocent enough; after all, why should anyone fear the government evaluating the effectiveness and comparing therapies and procedures?  Even the Joint Explanatory Statement of the Committee of Conference, which provides the legislative history and intent of Congress, assures Americans that the “conferees do not intend for the comparative effectiveness funding…to be used to mandate coverage, reimbursement, or other policies” and that the conferees “recognize that a ‘one-size-fits all’ approach to patient treatment is not the most medically appropriate solution to treating various conditions,” many health policy gurus remain concerned.  As President Ronald Reagan used to say, “the nine most terrifying words in the English language are: “I’m from the government and I’m here to help.”

Consumers and patients have a right to be concerned that this provision could have serious consequences, such as health rationing.  After all, the original language in the House-proposed stimulus package stated, “those items, procedures, and interventions that are most effective to prevent, control, and treat health conditions will be utilized, while those that are found to be less effective and in some cases, more expensive, will no longer be prescribed.”  Nina Owcharenko, health expert at the Heritage Foundation stated, “this type of alarming language is similar to what exists today in the British National Health Service (NHS).”

The National Institute for Health and Clinical Excellence, with the ironic acronym of NICE, is an independent advisory group that provides guidance on the use of new and existing medicines, treatments and procedures within the National Health Service and the appropriate treatment and care of people with specific diseases.  This sounds like a good idea, but not if you are a kidney cancer patient.  Last August, it was announced that kidney cancer patients would be denied four drugs after it was determined they were “too expensive.”  The likely result is an early death for many patients.

Try an Internet search on “macular degeneration; Britain; and blind-in-one eye” and there will appear a series of stories on how patients in Great Britain are forced to go blind in one eye due to wet macular degeneration and develop the disease in the other eye before they will be treated with the appropriate drugs to prevent them from going completely blind.

Additional research reveals that people who suffer from kidney disease in Great Britain have great difficulty accessing kidney dialysis.  The disease claims the lives of 7,000 citizens a year, many prematurely.

The comparative provision is similar to what former Senator Tom Daschle called for in his book “Critical - What We Can Do About the Health-Care Crisis.”  The board would be modeled after the Federal Reserve.  Considering the economic mess the nation is in right now, that shouldn’t give patients much comfort.  According to Daschle, the board would “help define evidence based health benefits and lower overall spending by determining which medicines, treatments, and procedures are most effective – and identifying those that do not justify their high price tag.”

In other words, bureaucratic potentates would ultimately tell physicians what to do with their patients.   This one-size-fits-all healthcare is not good for anyone, especially senior citizens who have paid taxes for decades.  They would likely be the first to face healthcare rationing.