Former Alaska Governor and Vice-Presidential candidate Sarah Palin caused quite the stir in 2009 when, in challenging the drafting of the Affordable Care Act, she stated that the bill would create a “death panel” of bureaucrats who would decide whether Americans—such as her elderly parents or children with certain disabilities were “worthy of medical care”.
But critics like Palin had already viewed Britain’s National Health Service (NHS) and its cost-effectiveness analysis to determine whether new treatments and drugs should be available to those covered by under the NHS. The Daily Telegraph took note and the Sunday Times wrote that Sarah Palin’s use of the “death panels” term was a reference to NICE (National Institute for Health and Clinical Excellence), which makes the analysis.
As a result some UK doctors write off patients as too old for treatment for cancer and other conditions. Les Scaife, an 83 year-old still working, developed skin and breast cancer. But before receiving treatment he was continually quizzed about his age which doctors claimed was to be sure fit enough for surgery. Nice try, but the patient’s age would have been well known to them without asking. The quizzing was an insidious attempt to intimidate him into backing away from treatment.
Scaife said “I did feel that there was something in the background there, that I felt that I wasn’t going to get the same treatment as someone younger than me. And I wanted to make the point that that wasn’t going to happen here. I’m entitled to the treatment that the illness deserves.”
Unfortunately, Scaife is an exception amongst the Brits. Most people in the UK simply won’t speak up. They have become conditioned to simply following what the government tells you to do; so when the NHS pronounces judgment (based on “cost-effectiveness analysis”), people in Britain resignedly just get in the end-of-life management line.
According to Macmillan Cancer Support, a charity providing information and financial help to those with cancer – patients are judged by age not symptoms. A Macmillan study showed that 81% of doctors would be willing to treat a 68-year-old cancer stricken woman with chemotherapy (so 1 in 5 wouldn’t); but make that woman a 73 year-old and only 47% of doctors would act the same way.
The study shows that 1 in 3 doctors see age 70 as a benchmark after which it is financially not worth treating patients, no doubt influenced by NICE. Additionally, it shows that an extra 14,000 Brits a year age 75+ would survive cancer if they received same treatment as Americans (pre-Obamacare).
Jagtar Dhanda of Macmillan said “Normal older people can withstand the consequences of treatment, live well with that treatment and as a result, what we are saying is we need to think about why they aren’t more survivable outcomes for over 65’s in the UK compared to Europe as a whole.”
Professor of cancer medicine and oncology Justin Stebbing responded “I think it’s happening less, is what I would say, maybe it does happen from time to time, it shouldn’t happen, but with research like this it will happen even less going forwards, we know that very fit people over the age of 65 can be cured of cancer or we can turn it into a chronic disease they can live with.”
Stebbing’s response is typically British! Confronted with the stark obvious he engages in a slow walk back of what has been the policy of many of his colleagues while passively explaining that the policy is in fact in retreat.
Ironically the Daily Mail, who led the UK’s charge against Palin in 2009 has run with a story this week about the travesty of pensioners (women over 60, men over 65) not securing the services they need from the NHS. They are right to point out that “Young lung cancer sufferers are only 10 per cent more likely to die within five years than their continental counterparts. But pensioners with the disease have 44 per cent less chance of survival.”
The Mail also quotes Caroline Abrahams, of the charity Age UK, who said “It’s good news that with the right care and treatment older people can survive for many years after cancer. It is often forgotten that people over 75 represent a third of all cancer diagnoses and a half of all cancer deaths. People over 80 with the disease are the only age group in which mortality rates have got worse in the last 40 years. An individual’s date of birth should not be used as a proxy for health and fitness or influence treatment decisions. Assessments of older people must be based on their needs and not simply on their age. Anything else is blatant age discrimination.”
Finally five years on people like Abrahams are being considered to have mainstream opinions to be acted on. Britain may finally becoming enlightened in this one area as they stop seeing people as simply not worth treating and a culture of life prevails.
Sarah Palin can feel vindicated though don’t expect to see apologies in the British press anytime soon. A prophet sounds a trumpet and makes the way for the coming of something new, but it is rarely without paying a great personal price.
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