We Don't Need NICE Healthcare

True believers in the proposition that nationalizing health care will save money seemed a bit shell-shocked recently by cost estimates from the Congressional Budget Office. Even as Congress reaches for ways to pay for the plan, defenders of quick action on health care inexplicably continue repeating the argument: "We've got to do this quickly to reduce costs for businesses and to speed the recovery."  Presidential Advisor David Axelrod declares, "At the end of the day, we'll have significant cost controls."  The United Kingdom is held up as an example for us in that it spends as little as half as much per capita for health care as the United States does.  This is true. But you get what you pay for. The UK contains its costs courtesy of N.I.C.E., the National Institute for Health and Clinical Excellence. NICE was established in the 1990's to ensure that the government-run National Health System used "best practices" in medicine."  It's become is a rationing board.  Health care costs have exploded in Britain, as they have in the U.S. and most developed countries. So NICE reduces spending by limiting treatment.

 A Wall Street Journal editorial detailed some of the cost-saving decisions made by NICE:

In March, NICE ruled against the use of two life-prolonging cancer drugs.  A NICE director said they would provide "marginal benefit quite often at an extreme cost."  In 2007, NICE restricted access to two drugs for macular degeneration.  One was allowed in certain cases, but then only for use on one eye. The chief executive of NICE said this plan would "give the most benefit to patients."  Tell that to the patients who went blind in the other eye.  Another drug, Aricept, is commonly used in the U.S. for early stage Alzheimers patients. British doctors, wanting to do the same were told the drugs were not "cost effective" in the early stages." NICE has rejected drugs to relieve rheumatoid arthritis, multiple sclerosis and multiple myeloma for which U.S. insurers cover all or part of the cost.

In the U.S., the stimulus package already funds a NICE-like board called the Council for Comparative Effectiveness.  It's not yet tasked with the level of authority accorded to NICE.  But with rising costs, the screws will be turned.

We certainly cannot take cost out of the health care equation.  As it is, insurance companies tell us what they'll cover and what they won't.  But handing these decisions to government makes them more arbitrary, not less. For instance, since most health care spending occurs during the last six months of life, NICE regulations currently stipulate that, except in unusual cases, Britain cannot spend more than $22,000 to extend a person's life by six months. Baby boomers...beware.

When a health care system moves under government control, a NICE-type system always becomes necessary.  Life and death treatment decisions become the responsibility of government bureaucrats.  The system needs reform. But not this.