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How House Bill Runs Over Grandma
...This administration, pledging to cut medical costs and for which "cost-effectiveness" is a new mantra, knows that a quarter of Medicare spending is made in a patient's final year of life. Certainly the British were aware when they nationalized their medical system.

The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror movie script.

The U.K.'s National Institute for Health and Clinical Excellence (NICE) basically figures out who deserves treatment by using a cost-utility analysis based on the "quality adjusted life year."

One year in perfect health gets you one point. Deductions are taken for blindness, for being in a wheelchair and so on....

...Can't happen here, you say? "One troubling provision of the House bill," writes Betsy McCaughey in the New York Post, "compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, Pages 425-430)."

One of the Obama administration's top medical care advisers is Oxford- and Harvard-educated bioethicist Ezekiel Emanuel. Yes, he's the brother of White House Chief of Staff Rahm Emanuel and has the ear of his brother and the president.

"Calls for changing physician training and culture are perennial and usually ignored," he wrote last June in the Journal of the American Medical Association. "However, the progression in end-of-life care mentality from 'do everything' to more palliative care shows that change in physician norms and practices is possible."

Emanuel sees a problem in the Hippocratic Oath doctors take to first do no harm, compelling them "as an imperative to do everything for the patient regardless of cost or effect on others," thereby avoiding the inevitable move toward "socially sustainable, cost-effective care."...