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October 2, 2009
Baucus Bill Requires Health Care Rationing, Death Panels by Proxy
Topics: Political News and commentariesThe Washington Times has taken a look at Senate Finance Chairman Max Baucus's health care overhaul legislation and found rationing and death panels cleverly disguised as accountants:
The offending provision is on Pages 80-81 of the unamended Baucus bill, hidden amid a lot of similar legislative mumbo-jumbo about Medicare payments to doctors. The key sentence: "Beginning in 2015, payment would be reduced by five percent if an aggregation of the physician's resource use is at or above the 90th percentile of national utilization." Translated into plain English, it means that in any year in which a particular doctor's average per-patient Medicare costs are in the top 10 percent in the nation, the feds will cut the doctor's payments by 5 percent.As Brian Faughnan points out at Redstate, this is a highly arbitrary and pernicious way to cut medical care for seniors:Forget results. This provision makes no account for the results of care, its quality or even its efficiency. It just says that if a doctor authorizes expensive care, no matter how successfully, the government will punish him by scrimping on what already is a low reimbursement rate for treating Medicare patients. The incentive, therefore, is for the doctor always to provide less care for his patients for fear of having his payments docked. And because no doctor will know who falls in the top 10 percent until year's end, or what total average costs will break the 10 percent threshold, the pressure will be intense to withhold care, and withhold care again, and then withhold it some more. Or at least to prescribe cheaper care, no matter how much less effective, in order to avoid the penalties.
The National Right to Life Committee concludes that this provision will cause a "death spiral" by "ensur[ing] that doctors are forced to ration care for their senior citizen patients." Every 10th doctor in the country will fall victim to it. Libertarian columnist Nat Hentoff calls the provision "insidious" and writes that "the nature of our final exit" will be very much at risk.
[...] This is far from the only part of Baucus-Pelosi-Obamacare that would almost certainly lead to rationing of care, especially for the elderly. The proposed "health care exchange," along with Obamacare's independent review panels and a national health board, will be empowered to make aggregate decisions - based on statistics, not on an individual patient's needs - about what sorts of care will be allowed and what won't. As it is in Great Britain, where thousands of cancer patients each year die prematurely due to lack of treatment, the inevitable result of government care could be the same for many Americans as if an actual panel decided case-by-case to euthanize them. The Baucus provision would only exacerbate this bureaucratic preference for death by proxy.
The Baucus approach penalizes the top ten percent every year. There is no target level of spending, after which the penalties sunset. Further, no provider ever knows if he or she is likely to end the year in the top ten percent. For that reason there is an incentive to cut costs on every patient, every procedure, every expenditure, on every day of the year. And if a doctor finishes the year in the bottom 90 percent, the average level of spending will have been reduced, and there will be a new contest to cut further, to remain in the bottom 90 percent the next year.And as if all this isn't bad enough, InsureBlog points out an equally insidious method of rationing - insidious because of its more subtle nature - significantly reducing the funds available for Medicare by straight across the board cuts - some of which are already planned before Obamacare:In practical terms, there's probably some point at which further rationing becomes politically impossible. Once Medicare expenditures and reimbursements are sufficiently reduced, once the federal government has adopted Oregon-style death panels to deny expensive care to the aged and infirm, Congress will likely have to step in to stop the 'death spiral.'
[...] Every Democrat on the Finance Committee voted to preserve the Medicare death spiral. Kent Conrad voted for it even as he recognized why it's a bad idea.
"Three-quarters of ObamaCare is to be financed by slashing $500 billion from Medicare over the next 10 years. That comes to an 8 percent cut."So what we see here is quite the contrary to what Rep. Alan Grayson, D-Fla., said during an after-hours House floor speech Tuesday night - that "Republicans want you to die quickly." In fact, the Republicans do have a health care plan and it doesn't require rationing or have a hidden death panel. But the Democrats won't even let it be discussed because they prefer to inflict their insidious will on the American people, whether we won't it or not. Clearly, the Democrats have chosen to forget that they work for us, not the other way around.That bears repeating: an 8% cut over and above other already planned reductions. In fact, even without ObamaCare's draconian cuts, there's a 21% reduction in Medicare reimbursement rates on the books for next year. That's a lot of office time that's not going to be reimbursed, and therefore never happen. How many elderly will be turned away, or made to wait for months (or longer) to be seen?
And that's before that 21% cut. Add the additional $50 billion (at least) that would be slashed by ObamaCare, and that's a lot of seasoned citizens left without health care options.
Contact your senator and representative, and voice your opinion now.
Posted by Richard at October 2, 2009 6:10 AM
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