Britain rations cortisone treatments for back pain
posted at 11:38 am on August 3, 2009 by Ed Morrissey
Not too long ago, a man in the UK pulled 13 of his own teeth rather than live in agony because the National Health Service didn’t have a dentist to treat his chronic teeth problems. His fellow Brits won’t have the option of using a pliers on their backs after the most recent rationing decision by the NHS. In order to save £33 million ($55.6 million), the British single-payer system will no longer give cortisone shots for nonspecific back pain despite the effectiveness of the treatment:
The Government’s drug rationing watchdog says “therapeutic” injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.
Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy. …
The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million.
Recall when Barack Obama promised that ObamaCare in the US would use the “best practices” of the medical industry, as determined by government panels, in order to dictate treatments and save costs? The actual experts in British medical circles warn that this will wind up increasing costs. Instead of offering new-age treatments rather than effective methods of pain control, the decision will push many to get surgery for relief instead:
But the British Pain Society, which represents specialists in the field, has written to NICE calling for the guidelines to be withdrawn after its members warned that they would lead to many patients having to undergo unnecessary and high-risk spinal surgery.
This demonstrates both the pretense and the folly of allowing the government to make these decisions in a noncompetitive environment, or really at all. The NICE, the supposed expert panel tasked with “clinical excellence,” isn’t concerned about the excellence of care at all. It’s concerned about spending money. Its priority is to reduce its budget, not to ensure that patients have effective pain relief. Cortison shots cost more than acupuncture and osteopathy, so they want to cut back by 95% on cortisone shots regardless of whether the shots are effective or the replacement treatments are not.
And what will that produce? More back surgeries, which cost a lot more than cortisone shots. That’s NICE.
ObamaCare supporters will argue that insurance companies make the same kinds of determinations about coverage of treatments. That’s certainly true, but they also have to compete with each other for business. They will lose customers if they make too many capricious and arbitrary decisions based solely on cost rather than effectiveness of treatment as those customers find insurers who provide better service. With no competition, as in the UK, the system never has to account for its caprice or its heartlessness.
Now, only the rich will get cortisone shots in the UK, because only they have the resources to get private medical care. The rest of the nation, which pays through the nose for the NHS, will get locked into those NICE decisions that focus on the bottom line rather than proper treatment. That’s what ObamaCare will deliver as well.
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