Had Jobs been under the care of the British National Health Service (NHS) or the Canadian Medicare system, he almost certainly would have died two years earlier. That would have been a major loss for the world, by anyone’s reckoning.

Here’s the back story. In 2004 Steve Jobs was diagnosed with pancreatic cancer. He reportedly underwent successful surgery. Then, in 2009 he received a liver transplant. …

[N]owhere else in the world would a pancreatic cancer survivor be considered an appropriate candidate for a liver transplant. In Jobs’ case, the transplant apparently bought him only about two more years of life. In no other developed country would a patient get a liver transplant in order to live two more years.

In Britain, the National Institute for Health and Clinical Excellence (NICE) is charged with deciding which treatments the British NHS will pay for and which it will not. NICE considers a treatment cost-effective only if the cost per quality adjusted life year (QALY) is £20,000 or less (about $31,000). Since the cost of a liver transplant plus two years of follow-up care are greater than that number, in Britain Jobs would not have made the cut.

Overall, the British Medical Journal estimates that 25,000 British cancer patients die prematurely every year because they do not get access to life-extending drugs readily available on the European continent and in this country. The British government reasons that the extra months of life the drugs will allow is not worth their cost.

Plus, Jobs’ end-of-life care enabled him to keep pushing the envelope. Because of his never-ending devotion to innovation, we got the iPhone after he was diagnosed with pancreatic cancer and the iPad after his liver transplant.

Goodman also points out that making it legal “compensate people for donating their organs in the case of an unforeseen death” [or before their death with kidneys] would decrease the “average of 20 people die each day waiting for transplants that can’t take place because of the shortage of donated organs. ”

Read the while post: Thank U.S. Health Care for the Life of Steve Jobs.

Here is the conventional wisdom in health policy:

• In the United States, we ration health care by price, whereas other developed countries rely on waiting and other non-price rationing mechanisms.
• The U.S. method is especially unfair to low-income families, who lack the ability to pay for the care they need.
• Because of this unfairness, there is vast inequality of access to care in the U.S.
• ObamaCare will be a boon to low-income families — especially the uninsured — because it will lower price barriers to care.

As it turns out, the conventional wisdom is completely wrong. Here is the alternative vision, loyal readers have consistently found at this blog:

• The major barrier to care for low-income families is the same in the U.S. as it is throughout the developed world: the time price of care and other non-price rationing mechanisms are far more important than the money price of care.
• The U.S. system is actually more egalitarian than the systems of many other developed countries, with the uninsured in the U.S., for example, getting more preventive care than the insured in Canada.
• The burdens of non-price rationing rise as income falls, with the lowest-income families facing the longest waiting times and the largest bureaucratic obstacles to care.
• ObamaCare, by lowering the money price of care for almost everybody while doing nothing to change supply, will intensify non-price rationing and may actually make access to care more difficult for those with the least financial resources.

Read the whole post: How We Ration Care | John Goodman’s Health Policy Blog | NCPA.org.

If the government stayed out of health care, or just subsidized Medicare enrollees with a voucher, then [some people] could purchase coverage for expensive cancer treatments.  [Others] could buy lower-cost insurance and donate the savings to scholarships.

Yet politicians and government bureaucrats dictate what type of insurance Medicare enrollees get, which means they also decide what enrollees will not get.  And no matter where they draw the line, someone loses. …

The only way out is Medicare vouchers.  In addition to being the most plausible way to reduce Medicare spending, vouchers are the only way to protect Medicare enrollees from government rationing.

Read the whole post: Provenge Controversy Argues for Medicare Vouchers.

A minor quibble I have is that the term “government rationing” is redundant. Don Watkins writes:

The difference between prices and rationing is the difference between you choosing what groceries to buy and the government telling you what food you’re allowed to eat.

Or, as Ronald Bailey has pointed out:

It’s not rationing if an individual decides to spend his money on a 16-ounce steak—but it is rationing if he can only purchase a USDA prime rib eye when he has a coupon issued from a government agency. In other words, true rationing occurs when individuals are forbidden from spending their money on products or services they want to buy.

The Food and Drug Administration (FDA) is on the verge of taking the highly unusual step of “decertifying” the cancer drug Avastin that it had previously approved. In addition to sparking concerns that this is another step towards medical rationing, the FDA’s proposal will worsen another important but less-frequently recognized danger of government-run health care — namely, the politicization of health benefits. Both problems will accelerate under ObamaCare unless our politicians repudiate the principle of government-run health care. …

If you had terminal cancer, who should decide what treatments you may receive during your last few irreplaceable months of life? You, in consultation with your doctor? Or politicians and bureaucrats in Washington, D.C.?

Unless we repeal ObamaCare [HR 3590], get ready for the latter choice.

Read the whole article at Pajamas Media: Avastin and Your Life.

Berwick praised the heavy-handed rationing methods of Britain’s National Institute for Health and Clinical Excellence (NICE) and said, “The decision is not whether or not we will ration care; the decision is whether we will ration with our eyes open.”…

Before Obama picked him to be our new Medicare czar, Berwick was the chief executive officer of an outfit he founded called the Institute for Health Care Improvement (IHI). IHI bills itself as a nonprofit charity, but it seems to do an awful lot of work on behalf of for-profit entities. As CEO of this enterprise, Dr. Berwick earned a cool $2.3 million in 2008. But, more to the point, IHI will provide him with private health care coverage during his declining years: “The Institute created a postretirement health benefit plan for its chief executive officer (CEO). It provides the CEO and his spouse medical insurance from retirement until death.”

In other words, Dr. Berwick has made sure that he and his wife will never be subjected to the tender mercies of Medicare, the health care program for seniors over which he now has control. Thus, even after he has implemented rationing programs modeled after those of NICE, he won’t have to worry about his wife suffering for lack of drugs deemed too pricey by some obscure comparative effectiveness calculation.

Read the whole article: Donald Berwick’s Motto? Rationing for Thee, but not for Me.

Paul Hsieh, MD connects this to a larger trend:

The arrogance of government officials like Berwick is astounding in a two-fold way.

First, they believe they are qualified to set draconian rules over the lives of the citizenry, because we are unable to make such decisions for ourselves. The typical excuse given is that it’s for our own good or for some nebulous “common good”.

But by exempting themselves from their own rules, they recognize (at some level) that these rules are actually bad for the individuals involved — but they don’t care.

Paul mentions environmentalists who jetset around the globe advocates of gun control who have bodyguards or exempt themselves from gun bans.  Read more here. To add to Paul’s examples, there are the politicians, like president Obama, who support the government school monopoly but send their kids to private schools.

President Obama is making a huge end-run around the American people with his recess appointment of Dr. Donald Berwick.

“This recess appointment is an insult to the American people,” said Sen. John Barrasso (R., Wyo.), a physician and leading Berwick opponent. “Dr. Berwick is a self professed supporter of rationing health care, and he won’t even have to explain his views to the American people in a hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent.” Berwick will have authority over an agency with the largest single budget in the entire U.S. government and over implementation of the most sweeping legislative overhaul of our health sector ever — without so much as a congressional hearing!

Berwick will run the Centers for Medicare and Medicaid Services (CMS), giving him control of its $800 billion budget during the crucial months when thousands of pages of regulations will be written, determining how Obamacare will be run. The recess appointment lasts through the first session of the next Congress in 2011, after which Berwick will have to be renominated and would likely face even greater opposition, assuming Republicans make expected gains in the Senate.

The reason Berwick’s nomination was so highly controversial: numerous statements he has made professing his love for socialized medicine.

Read the whole article: Obama Appoints His Rationer-in-Chief.

Suppose our government declared that everyone had the “right” to a nice steak dinner. The government would require restaurants to sell $50 steak dinners to all comers. But to keep prices affordable, restaurants could only charge $25. No restaurant could survive long under such a scheme, and most Americans would be outraged at such a blatant violation of restaurant owners’ rights.

But that is exactly what is happening with health insurance in Massachusetts. Events unfolding now in the Bay State should serve as a warning to the rest of America of the danger ObamaCare poses to our health insurance, our health care — and ultimately our lives. …

However, insurers are not allowed to set prices based on market conditions, but must instead petition the state for rate increases.

Recently, the Massachusetts state insurance commissioner rejected 235 of 274 requested rate increases.

Insurers filed suit against the state, arguing that without these rate increases they would be forced to sell their services at a loss. The state then “delisted” the complaining insurers from the government-run exchange where residents purchase plans. Under government pressure, at least two insurers then agreed to resume sales under the old prices.

Insurance companies in Massachusetts are thus required to offer numerous benefits as determined by politicians and lobbyists, but they may only charge what government bureaucrats permit. It would be akin to the government requiring restaurants to sell $50 steak dinners, but only allowing them to charge $25.

Read the whole article: ObamaCare: Insurers Need Permission to Survive; Citizens, to Live.

From Americans for Prosperity:

Tracy Walsh survived her fight with breast cancer because of early detection. The testing that saved her life is being discouraged by government bureaucrats and could become more common with a government take over of health care

…low-income women in at least 20 states are being turned away or put on long waiting lists for free cancer screenings, according to the American Cancer Society’s Cancer Action Network. In the unofficial survey of programs for July 2008 through April 2009, the organization found that state budget strains are forcing some programs to reject people who would otherwise qualify for free mammograms and Pap smears.

…

New York used to screen women of all ages, but this year the budget crunch has forced them to focus on those considered at highest risk and exclude women under 50….

At least 14 states cut budgets for free cancer screenings this year: Colorado, Montana, Illinois, Alabama, Minnesota, Connecticut, South Carolina, Utah, Missouri, Washington, Ohio, Massachusetts, Pennsylvania and Arkansas.