It's nowhere close to the death panels Sarah Palin warned of during the debate over the health care overhaul legislation.
Nor is it rationing exactly. But Washington State has a committee that decides what medical procedures and devices the state will pay for when it comes to the government workers and recipients of Medicaid and state disability benefits it insures.
The New York Times' Andrew Pollack reports that some critics of the federal health care law which just had its one-year anniversary fear the Washington State Health Technology Assessment committee is the shape of things to come.
One of the most damning thing in critics' eyes, apparently, is that the panel uses evidence-based practice to determine what to pay for.
Evidence-based medicine is controversial in part because of disagreements over what exactly constitutes "evidence."
Also, many physicians and manufacturers who could potentially come up on the short end of payment decisions based on its use often express doubts about its validity.
The program is also drawing attention because it explicitly considers the cost of treatments in making its decisions, akin to Britain's National Institute for Health and Clinical Excellence.
That similarity alone has made the Washington program the target of criticism from opponents of the new federal health care legislation. Last Friday, The Wall Street Journal's editorial board, a longtime opponent of the federal law, called Washington State's process a harbinger of limitation of choice that it said would result from the national health care overhaul, which includes undertaking efforts to compare the effectiveness of different therapies.
In the Daily Caller story, Rep. Phil Roe (R-TN) calls it the "real death panel" though it sounds like what it's trying to accomplish is a lot like what Washington State's panel is going for.
The Washington State panel is evidently making many people in health care anxious as state policymakers around the nation look to it for inspiration.
"I think there is evidence that other states look at what they do," said Rob Clark, senior director for state government affairs at Medtronic, who attended Friday's meeting.
Before that meeting, the committee, created by a 2006 law that had bipartisan support, had ruled on 21 devices or procedures, rejecting coverage for about half of them, including arthroscopic knee surgery and calcium scoring for cardiac disease. Virtual colonoscopywas rejected explicitly because it cost more than conventional colonoscopy.
It's an interesting story about a part of the health-care bureaucracy in Washington State that would have toiled in relative obscurity a few years ago. But no longer, thanks to the changed national health-care landscape.