If you haven’t, read Erick’s post about an Oregon public health plan (”public option”) administrator responding to a cancer patient’s request for subsidized chemotherapy with a denial of treatment but an offer to fund a physician-assisted suicide.

Now, know this: over the course of this decade, the state of Oregon has put in place a formal procedure for rationing care to patients whose health coverage is subsidized by government (i.e., who are enrolled in some form of the state’s “public option”). To date, they are the only government in the world to have formally done this, though many — from Britain to Canada to states here in the U.S. — work “cost-effectiveness” into their official denials of medical treatment.

After beginning the process of determining the cost-effectiveness (to the state) of hundreds of medical treatments and procedures in 2002, the Oregon Health Services Commission narrowed down the number they were willing to entertain offering coverage for to 680, ranked in order of state priority. This year — 2009 — the state will only reimburse physicians for performing procedures and offering treatments ranked in the top 503, in ascending order of priority.

Recipe for Denial of Care

WHAT THIS MEANS, of course, is that a patient enrolled in the “public option” who was in need of a treatment or procedure the commission decided to rank 503rd or below in priority would be ineligible for that procedure — period. Further, state bureaucrats balancing Oregon’s figurative checkbook could decide that the Beaver State only had enough health care dollars to fund some of the procedures on the list. This is where the prioritization comes in: under the state’s rationing procedure, a person in need of an emergency appendectomy (prioritized 84th by the the state of Oregon) would be denied that treatment before an individual in need of treatment for “tobacco dependence” (ranked 6th).

Does that sound a bit perverse to you? How about this: the state rationing board ranked abortion 41st overall in state-funding priority, meaning the bureaucrats who designed the priority structure in this “public option” program determined that the use of taxpayer funds for abortion is more important (and more medically necessary) than covering injuries to major blood vessels (ranked 86th), surgery to repair injured internal organs (88th), a “deep wound to the neck” or open fracture of the larynx or trachea (91st), or a ruptured aortic aneurysm (306th).

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Update by Jeff: Perhaps this comment will shine a bit more light on the import of this issue.

WHO SHOULD HAVE CONTROL over your medical care: your family doctor, or a bureaucrat you’ve never met whose sole job is to look out for the government’s financial bottom-line?

That question, which is the subject of today’s AOL Hot Seat poll, is being debated in court right now, as three states are currently seeking a ruling from a federal judge that the final say in an individual’s medical treatment lies with the government, not with that patient’s doctor.

In March, Georgia, Florida, and Alabama joined in an appeal of a 2008 U.S. District Court ruling that a patient’s physician was better positioned – and better qualified – to make decisions about that patient’s medical treatment than state bureaucrats.

The case centers on Callie Moore, a disabled teenage girl living in Georgia. A stroke Callie suffered in utero left her suffering from multiple conditions, including cerebral palsy and mental retardation. For the last decade, she has received around-the-clock in-home nursing care for her medical conditions.

IN 2007, THOUGH, the state of Georgia cut coverage of Callie’s in-home care by 15%, from 94 hours a week to 84 over the objections of her attending physician, who was intimately familiar with her case and her needs. State officials (who were not medical professionals) cited disagreement with the attending physician about just how much care Callie needed as the primary reason for this reduction in care.

Callie’s mother filed suit in 2007, arguing that the state had no right to contradict the orders of her personal physician and limit her treatment. However, because Callie receives her medical treatment under Medicaid, the joint federal-state administered health coverage program for low-income individuals and families, Georgia officials argued that Callie’s care was subject to rationing, as state bureaucrats’ need to ensure Medicaid resources were allocated “fairly” superseded her doctor’s care prescription or her personal medical needs.

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Yesterday, Congress heard a report that yet another government bureaucracy that failed in its duties to the American people. Now, imagine what would happen if those same people were in charge of your health care.

One of the benefits of reading a lot of judicial opinions, as I do, is that you get to see a lot of retail examples of how our government operates at its most legalistic-bureaucratic. Yesterday’s opinion by the U.S. Court of Appeals for the First Circuit in River Street Donuts, LLC v. Napolitano is a wonderful little vignette about a bureaucratic system run amok.

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The defense of Bobby Jindal began here at RedState. You can read more about it here, here, here, and here.

To summarize: Some guy named Zachary Roth is apparently offended that Bobby Jindal is not a Democrat due to his skin color. Roth, who is apparently overly emotional, constructed a fable distorting Jindal’s story about Sheriff Harry Lee. The lefty blogs and MSNBC picked it up and broadcast Roth’s fable as truth and the true story as a fable.

The attacks are, superficially, about Jindal — a popular Republican who might one day challenge Obama. But dig deep, and the attacks are really about big government.

Here’s the story as recounted by Governor Jindal in the Republican response to Barack Obama’s non-State of the Union State of the Union Address:

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