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One of the continuing themes, in my build up toward Universal Health Care has been the documentation of the rationing of services that starts once the government starts paying for your "free" health care. The posts in question can be found here. Commenters and politicians and reporters assure us that nothing like that will ever happen here, but are they correct? If Article 5 Section 10 is any indication.....
42.14 Sec. 10. [62U.05] HEALTH TECHNOLOGY ASSESSMENT.
42.15 Subdivision 1.Technology Advisory Committee.(a) The Health Care
42.16Transformation Commission shall convene an advisory committee to make
42.17recommendations to the commission regarding the inclusion of new and existing health
42.18technologies to the standard benefit set and design.
42.19 (b) The advisory committee shall be made up of 11 members appointed by the
42.20commission, in consultation with the Institute for Clinical Systems Improvement, the
42.21Health Services Advisory Council, and the University of Minnesota. The members shall
42.22consist of:
42.23 (1) six practicing physicians licensed under chapter 147; and
42.24 (2) five other practicing health care professionals who use health technology in
42.25their scope of practice.
42.26 (c) No member of the advisory committee shall have a substantial financial interest
42.27in a health technology company or be employed by or under contract with a health
42.28technology manufacturer during their term or for 18 months before their appointment.
42.29 (d) The members shall be immune from civil liability for any official acts performed
42.30in good faith as members of the committee.
42.31 (e) The advisory committee shall be governed under section 15.059, except that
42.32the committee shall not expire. Upon the expiration of the Health Care Transformation
42.33Commission, the Health Technology Assessment Committee shall continue to exist under
42.34the oversight of the Minnesota Health Insurance Exchange.
43.1 Subd. 2. Technology selection process. The commission, in consultation with the
43.2advisory committee, shall select existing and new health technologies to be reviewed by
43.3the committee. In making a selection, priority must be given to any technology for which:
43.4 (1) there are concerns about its safety, efficacy, or cost effectiveness;
43.5 (2) actual or expected expenditures are high due to demand for the technology,
43.6its cost, or both; and
43.7 (3) there is adequate evidence available to conduct a complete review.
43.8 Subd. 3. Technology review. (a) Upon the selection of a health technology for
43.9review, the committee shall contract for a systematic evidence-based assessment of
43.10the technology's safety, efficacy, and cost effectiveness. The contract must be with an
43.11evidence-based practice center designated as such by the federal agency for health care
43.12research and quality, or another appropriate entity as designated by the commission.
43.13 (b) The committee shall provide notification to the public when a health technology
43.14has been selected for review. The notification must indicate when that review is to be
43.15initiated and how an interested party may submit evidence or provide public comment for
43.16consideration during the review.
43.17 Subd. 4.Committee determination. (a) Upon reviewing the completed assessment
43.18and any other evidence submitted regarding the safety, efficacy, and cost effectiveness of
43.19the technology, the committee shall recommend to the commission:
43.20 (1) the conditions, if any, under which the health technology should be included
43.21as a covered benefit; and
43.22 (2) if covered, the criteria to be used to decide whether the technology is medically
43.23necessary, or proper and necessary treatment.
43.24 (b) The commissioners of human services, employee relations, and corrections may
43.25use the committee's recommendation in making coverage and reimbursement decisions,
43.26unless the recommendation conflicts with an applicable federal statute or regulation
Can I just say one thing.....I TOLD YOU SO!
If you think that getting your HMO to approve experimental treatments (under todays existing market based system) is bad just wait until you have to argue for that care in front of a board of doctors who are accountable to the Legislature and not to you and your health.
Cross posted at Ladies Logic |
