NICE in America?

NICE, or the National Institute for Health and Clinical Excellence, is a British authority that is in charge of making sure that the country’s national health care system uses “best practices” to “root out under-performing doctors and useless treatments, spreading best practices everywhere.”

Does that language sound familiar? It should — we hear something very similar from President Obama nearly every day, certainly in every speech he makes about health care reform. The president believes that if we can just find the most efficient treatments and eliminate unnecessary procedures and prescriptions, we can find health care savings that will help pay for a $1 trillion overhaul of the U.S. health system.

So how does NICE do what the president wants to accomplish? How does Britain manage to spend half as much, per patient, as the United States?

NICE lowers costs by denying health care to Britons who would be too expensive to care for. The bureaucracy has calculated a limit of about $22,000 as the maximum price they’re willing to pay to extend a life by six months — a figure that was set years ago and is not adjusted for inflation. New and often effective drugs and procedures are kept off the market if their costs are too high, and some people are simply told that their life is too expensive to save.

This system is the direct result of a government-controlled single payer for insurance — exactly what the “public option” could become if it is given enough advantages to crowd out private insurers. If that happens, as it’s likely to, it’s no stretch to say that the next step to keep costs under control will be the same sort of rationing that English and Canadian patients endure. The NICE language is already here.

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