ObamaCare Attempts to Repair Image on Children’s Health

June 2013 was a disastrous month for ObamaCare with bad press at every turn. In early June, a study was published indicating that if all states “opt in” to ObamaCare, the number of uninsured individuals would still be 29.8 million. The bad news? – If all states “opt out” the number is projected as only 31 million! In other words, the net effect of trillions in spending may be only an additional 1.2 million insured! By the way, this 30 million uninsured level is echoed by a February 2013 CBO (Congressional Budget Office) study that shows a level rate of 30 million uninsured through 2023! Whatever happened to the campaign promises to insure 40 million folks?

The bad news continued with GAO (General Accountability Office) reports indicating that the exchange systems and other aspects of ObamaCare were well behind schedule and could not meet their target dates. This failure to meet milestones has played a role in the July 2013 announcement of a one year delay in implementation.

Perhaps, though, the worst ObamaCare nightmare was the Sarah Murnaghan story. A 10-year old Pennsylvania girl with cystic fibrosis was denied access to adult donors under existing guidelines which set a lower age limit of 12. Secretary Sebelius said that she could not intervene and stay the guidelines, issuing her now-famous quote: “Someone lives, someone dies.” The girl’s parents appealed this decision and the District Court issued a temporary injunction that set aside the guideline and instructed Secretary Sebelius to grant Sarah Murnaghan access to the donor network. While Secretary Sebelius argued that adults could die as a result of this decision, part of the thinking expressed in Court was the one-dimensionality of the criteria for children’s access to adult organs – based solely on age and not considering the urgency of the medical circumstances or any other factor. In fact, children under 12 are about three times as likely to die waiting for a lung transplant as are their over-12 counterparts.

Subsequently, Ms. Murnaghan received the transplant and is still alive and recovering at this point. The same may not be true for ObamaCare, which suffered a fall in popularity as a result of the above bad publicity. Gallup reported a seven point swing in unfavorability from 45% last fall to 52% in June.

In view of wavering support and low enrollment, the Obama administration and its political wing are struggling to create a favorable impression of ObamaCare using advertisements, and seeking the endorsement of celebrities and athletes. Organizing for Action (An official Obama organization) has issued a new ad showing how ObamaCare has helped a little girl who needed open heart surgery, and who, in time, could have bumped up against a ‘lifetime cap” on benefits. I had trouble playing this video at neutral sites – being informed there was no access because it was “private.” I did eventually find it at

http://www.barackobama.com/health-care/

Actually, this is a rehash of the Zoe Lihn story used to great emotional effect at the Democratic Convention last year. She may just be the only child in the U.S. to actually be helped by ObamaCare, and so she is being trotted out again as a prop in this campaign to garner favorable public opinion.

But the issue is far wider than anecdotal evidence regarding one little girl from Pennsylvania or her counterbalance in Spinland. Let’s take a look at how a centrally planned, rationally conceived health care scheme would apportion scarce health care resources to all children, as well as all adults, based on age. This graph was published in the Lancet by Dr. Ezekiel Emanuel, an Obama health care advisor who helped frame ObamaCare, and represents his logical, ideal apportionment of scarce health care resources (click to enlarge):

Target Allocation of Health Care Resources by Age

Target Allocation of Health Care Resources by Age

Note that to the far right, at age 60 and older, the probability of receiving care is about one-fourth that of an individual between 20 and 30. Dr. Emanuel argued that these seniors had already had “complete lives” and intervention was not as important as for a younger person.

Note that to the far left, at age 10 and younger, the probability of receiving care ranges from about one-half to one-tenth that of an individual 20 to 30 years old. This is explained by Dr. Emanuel as reflecting the fact that society has not invested as much (for education etc.) in such children as it has in young adults, and therefore it is not cost effective to spend large sums to save them. This category is the one in which Sarah Murnaghan found herself, and therefore it is not surprising that the rules created by the transplant network limits her access to about one-third of that for older patients. In fact, to quiet the news crisis, Secretary Sebelius asked the board to review their criteria, and that review so far has changed nothing, nor will it in the future, unless Public opinion can be converted to political leverage.

As for the little girl in the Obama commercial who is receiving large expenditures of resources for her cardiac condition at age 1, I can only think that she may be the temporary beneficiary of the need to sell this program to a still-doubting Public. Once ObamaCare becomes a firmly ensconced, monolithic, and unrepealable health care machine, I would expect the bureaucrats to revert to form and greatly rein in expenditures for such a young person to be more in line with the one-tenth of young adult level. After all, their ideal health care resource curve calls for that, and, as Secretary Sebelius pointed out, she can’t make exceptions to these rules and guidelines.

By the way, the image of the Murnaghans pleading for their daughter’s life fulfils exactly my prediction that under this new arbitrary system, the citizens will find themselves on their knees, begging for health care for themselves and their loved ones. Evidently, it will take actual Court orders to obtain such mercy. Unbelievable! In a system that boasts that it exists “for the people,” I don’t think this is the proper relationship between the government and the governed. Do you?

the Sceptic

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