A checklist to die: Obamacare´s death tests and panels

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“Obamacare’s shoddy implementation doesn’t even begin to scratch the surface of its great evil,” reported Breitbart late last year, referring to the healthcare rationing that is insidiously hidden within the pages of the evasive law. Perhaps the most alarming criterion of healthcare rationing found in the Affordable Care Act (ACA) is the plan’s death panel language. Democrats vehemently denied that death panels would play a role in the ACA, but the law itself states that doctors will be paid to have discussions with patients about living wills, advance directives, and end-of-life options. 
 
Killing patients whose perceived utility is declining is not exclusively an American phenomenon. The idea has shaped the healthcare system in the UK for decades, where the Liverpool Care Pathway (LCP) has been a fixture of end-of-life care. Unfortunately, however, the LCP has morphed into a utilitarian means of freeing hospital beds and lowering healthcare costs – the unavoidable slippery slope that is presented any time the value of human beings is measured in monetary terms (as socialized healthcare plans do).  The LCP has been engulfed in controversy in recent years and has signaled a possible end to the program.  After repeated cases of shocking abuse, LCP will be phased out through the elimination of pallative care options for patients in the final days or hours of life
 
Similarly, Australia has just released a 29-point checklist to be used by physicians to determine whether an elderly person is likely to die within 30 days. The checklist includes criteria such as low blood pressure, high- or low pulse, hypoglycemia, and low urinary output. But critics of the checklist posit the fact that human beings routinely defy mathematical odds and believe that aligning the probabilities of life or death with a checklist is demeaning. 
 
With the ACA, America descends down the same dangerous paths. In addition to the ACA’s death panel language, there are shocking discrepancies between mainstream medical recommendations for preventive and diagnostic care, and provisions for such care as recommended by the federal government. 
 
The US Preventive Services Task Force (PSTF) is the Congress-appointed body whose job is to recommend guidelines for preventive services, screenings, and medications. In conjunction with Obamacare, the Task Force recommendations have become conspicuously stingier.
 
For example, the Task Force only recommends routine mammograms for women ages 50-74, while the Mayo Clinic and the American Cancer Society both recommend annual mammograms for women over age 40 (without the cap at age 74). In fact, findings from a large study indicate that breast cancer deaths decreased by nearly 30% in women who obtained annual screenings starting at age 40.  Similar discrepancies exist between Task Force recommendations for colonoscopies and prostate cancer screenings, and those of widely-respected medical associations. 
 
According to the Annals of Family Medicine, Breitbart continues, the Secretary of the Department of Health and Human Services (currently Sylvia Burwell; formerly disgraced Kathleen Sebelius) possesses the power to add and remove preventive services based on their rating by the Preventive Services Task Force. Checks and balances? We think not. 
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