Trump Medicare plan creates Obamacare-styled AI death panels
Donald Trump is piloting a new Medicare plan that requires patients to receive prior approval from the government before undergoing medical procedures, creating AI death panels much like the Obamacare-styled death panels once demonized by so-called conservatives.
Prior authorization will be granted or denied by . . . are you ready? . . . Artificial Intelligence (AI) in the name of “cost controls” (via NationOfChange.org):
The Trump administration is launching a pilot program in six states that will allow artificial intelligence to help decide whether elderly Americans can receive certain medical procedures under traditional Medicare. The move has been likened by critics to the creation of “AI death panels,” with experts and advocates warning it risks importing the most unpopular practices of private insurance into the federal health program.
The pilot, officially named the Wasteful and Inappropriate Service Reduction Model, is scheduled to begin in January and last six years. It will run in Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. Under the program, the Centers for Medicare and Medicaid Services will hire private companies to use A.I. tools to make “prior authorization” decisions—determinations about whether Medicare will pay for particular procedures.
Private companies? What do you think the odds are that Peter Theil and Palantir will be getting the contract?
The death panel connection between Trump and Obama has been well established. In the first year that Obamacare was the law of the land, there was a growing debate about government’s desire to pick winners and losers in the healthcare game via “death panels” and healthcare rationing. While this never officially happened, COVID tyranny created an opportunity for government death panels the new normal.
In a story carried by the Denver Post during the early days of Obamacare, we were given a picture of what death panels and healthcare rationing looked like in a report about how the “nation’s organ-transplant network [was] considering giving younger, healthier people preference over older, sicker patients for the best kidneys.”
Instead of giving priority primarily to patients who have been on the waiting list longest, the new rules would match recipients and organs to a greater extent based on factors such as age and health to try to maximize the number of years provided by each kidney, the most sought-after organ for transplants.
“We’re trying to best utilize the gift of the donated organ,” said Kenneth Andreoni, an associate professor of surgery at Ohio State University who chairs the committee that is reviewing the system for the United Network for Organ Sharing, a Virginia-based private nonprofit group contracted by the federal government to coordinate organ allocation. (emphasis mine)
“Best utilized” was politispeak for “sorry grandma, but you simply won’t live long enough for Uncle Sam to recoup his investment.”
When questioned about the ethical and moral issues of denying someone life-saving care simply because they are too old or too sick, Arthur Caplan, a University of Pennsylvania bioethicist, had this to say”
“It’s a big shift. For a long time, the whole program has been oriented toward waiting-list time. This is moving it away from a save-the-sickest strategy to trying to get a greater yield in terms of years of life saved.” (Emphasis mine)
While this study was specific to kidney transplants, Caplan went on to admit that this same approach could be applied in other situations. For example:
“If adopted, the approach could have implications for other decisions about how to allocate scarce medical resources, such as expensive cancer drugs and ventilators during hurricanes and other emergencies.” (Emphasis mine)
I shared this nearly 14-years-old article to show how death panels and healthcare rationing have always been a part of government’s healthcare agenda. However, it wasn’t until COVID that we saw the practical application of the policy.
In the early days of the so-called pandemic, the LA Times reported that southern California’s medical system was denying critical medical care to everyone who needed it due to COVID. In the name of what socialist/communist countries like Russia refer to as the “common good,” the state rationed healthcare while deciding who gets to live and who gets to die in the war against the so-called pandemic to ensure Big Brother gets the biggest return on resources.
Many hospitals are preparing for the possibility of rationing care in the coming weeks as the number of patients exceeds their staffs’ abilities to care for them. A document obtained by The Times outlining how to allocate resources in a crisis situation was recently circulated among doctors at the four hospitals run by Los Angeles County.
The guidelines call for a shift in mindset that is unfamiliar to many medical providers.
Instead of trying everything to save a patient, their goal during a crisis is to save as many patients as possible, meaning those less likely to survive will not receive the same level of care they would have otherwise. Doctors will no longer be pulling out all the stops to save a life but instead strategizing about how to keep as many people as possible from perishing. (Emphasis mine)
In the LA Times article, we read how this god-like power to decide who lives and who dies during COVID was justified by the bureaucrats and other “essential” workers who, unsurprisingly, enjoy the protection of the state.
The county memo said the shortages are unlikely to be of tools like ventilators but instead of highly trained staff, specifically respiratory therapists, ICU nurses and critical care physicians. Decisions would be made by an appointed triage officer. For patients who receive a scarce resource, they will be given up to two days to see if it is helping, at which point they should be reassessed to determine whether the treatment should continue.
If the patient has not shown improvement or has gotten worse, the resource may be reallocated to someone else.
“The ethical justification … is that in a public health emergency when there are not enough critical care resources for all, the goal of maximizing population outcomes would be jeopardized if patients who were determined to be unlikely to survive were allowed indefinite use of scarce resources,” the document states. (emphasis mine)
When Barack Obama was challenged about death panels and healthcare rationing under Obamacare, he wrote it off in an address to a joint session of Congress as conservative hyperbole, saying that there wouldn’t be any government bureaucrats making life and death decisions about whether-or-not seniors will receive life-saving healthcare:
“Some of people’s concerns (about the health care legislation) have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but by prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Now, such a charge would be laughable if it weren’t so cynical and irresponsible. It is a lie, plain and simple.” (Emphasis mine)
It could be argued that Obama gave an honest answer because bureaucrats weren’t given the job to decide who will or will not receive healthcare, that job was given to non-government bureaucrats receiving funds from the government — just like now with Donald Trump at the helm.
Under Trump’s plan, the federal government will hire private companies who will use artificial intelligence (AI) to evaluate whether patients would be covered for procedures such as skin and tissue substitutes, electrical nerve stimulator implants and knee arthroscopy for knee osteoarthritis.
Like Obama, Trump also claims that AI death panels won’t be making final decisions on whether or not seniors will be denied services, but also like Obama, this is only partially true because a decision will still be made, only it “will be made by licensed clinicians, not machines.”
And here’s another serious consequence of AI death panels: Even though, as Trump claims, humans will be making the final determination concerning approval or denial, the structure of his Medicare program is fraught with opportunities for corruption because “Medicare plans to pay them a share of the savings generated from rejections” — setting the stage for numerous denials to make sure third party contractors pocket plenty of money.
Unfortunately for the elderly, the poor, and anyone else the state deems unworthy of Medicare, Donald Trump will let AI death panels do the work Obama only dreamed of.
David Leach is the owner of the Strident Conservative and the author of The New Axis of Evil: Exposing the Bipartisan War on Liberty. He holds people of every political stripe accountable for their failure to uphold conservative values, and he promotes those values instead of political parties.
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