Medical Guidelines... for Genocide

June 5 (LPAC)—When you go to the doctor, do you want a statistician, or a physician to treat you?        

Britain's National Institute for Clinical Excellence (Not-NICE), whose genocidal cost-cutting policies have been documented by LPAC, has been working for the last 10 years to impose  medicine run by statisticians wielding cost-benefit analysis, as global practice. They sold the program as establishing "common frameworks for assessing clinical practice guidelines;" that is, guidelines requiring doctors to prescribe only the medicines and treatments which their statisticians have shown to save private insurers the most money.        

In 1998, NICE helped create AGREE, a European-wide network of policy makers and "researchers" with a self-proclaimed mandate to forge consensus around "a shared framework" for developing, reporting and assessing approved guidelines for clinical practice (AGREE being the nice acronym for Appraisal of Guidelines Research and Evaluation). U.S., Canadian, and New Zealand "researchers" were invited to join the European Union-funded group representing the core European countries (Denmark, Finland, France, Germany, Italy, the Netherlands, Spain, Switzerland, and the United Kingdom). In 2001, AGREE members from the UK, Netherlands and Germany initiated the creation of a broader Guidelines International Network, "to harmonise" methodologies for developing "guidelines" globally. That GIN today involves people from 90 countries. Playing a key role each step of the way, was NICE's Francoise Cluzeau.        

Now, the Obama administration asserts that cost-reduction requires the U.S. Congress to mandate that all Medicare payments be tied to meeting such NICE guidelines. Since 2003, pilot projects have been run in more than 260 hospitals, where physicians and institutions which meet approved guidelines are rewarded, a program dubbed "pay for performance." Private insurers have similar incentive programs.        
Medicine by "guidelines" is the cornerstone of the infamous Massachusetts health insurance system, whose fatal results were exposed on April 8, 2009 in the Wall Street Journal by two Massachusetts doctors, Jerome Groopman and Pamela Hartzband. Doctors who don't adhere to guidelines are publicly discredited, and their patients required to pay up to three times as much out of pocket to see them, Groopman and Hartzband report. But standardized care is methodologically insane, and leads to deaths. Repeatedly, standardized metrics for assessing physician performance have been overturned, when studies found the shoe that fit one, might kill another. (E.g.: the New England Journal of Medicine reported in June 2008 on one 10,000 person study of ambulatory diabetics with cardiovascular disease which was discontinued early, after many diabetics died in the group requiring rigid maintenance of normal blood sugar levels, a "guideline" required for approved physician performance.)        

Doctors Groopman and Hartzband point to other ways in which NICE "payment for performance" programs foster fatalities: pushing physicians to drop patients whose illnesses have poor prognoses, or whose outcomes would ruin their statistics. These practices were found in a study of 35,000 physicians caring for 6.2 million patients in California, reported in Health Affairs.        

Research by the Brigham and Women's Hospital published in the Journal of the American College of Cardiology in March, 2009, "indicates that report cards may be pushing Massachusetts cardiologists to deny life-saving procedures to very sick heart patients, out of fear of receiving a low grade if the outcome is poor," the doctors wrote.