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How Obama’s public option would ration specialized care

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Story from the Wall Street Journal. (H/T ECM)

Excerpt:

Take a provision in the Baucus bill that would punish any physician whose “resource use” is considered too high. Beginning in 2015, Medicare would rank doctors against their peers based on how much they cost the program—and then automatically cut all payments by 5% to anyone who falls into the 90th percentile or above. In practice, this rule will only apply to specialists.

[…]In Medicare, meanwhile, the Administration is using regulation to change how doctors are paid to benefit general practitioners, internists and family physicians. In next year’s fee schedule, they’ll see higher payments on the order of 6% to 8%.

[…]this boost for GPs comes at the expense of certain specialties. The 2010 rules, which will be finalized next month, visit an 11% overall cut on cardiology and 19% on radiation oncology. They’re targets only because of cost: Two-thirds of morbidity or mortality among Medicare patients owes to cancer or heart disease.

[…]The basic tools of heart specialists—echocardiograms (stress tests) and catheterizations—are slashed by 42% and 24%, respectively.

[…]Cancer doctors get hit because the Administration believes specialists order too many MRIs and CT scans. Certain kinds of diagnostic imaging lose 24% under new assumptions that machines are in use 90% of the time, up from 50%. There isn’t a radiologist in America running an MRI 10.8 hours out of 12, unless he’s lining up patients on a conveyor belt. But claiming scanners are used far more often than they really are lets the Administration “score” spending cuts.

And this change is applied to all expensive equipment, not just MRIs and CTs, so payments for antitumor radiation therapy will fall by up to 44%.

This will primarily affect the middle-aged and the elderly.

The case of Ontario, Canada

Here’s how it works in Ontario, Canada according the the National Post. (H/T Secondhand Smoke via ECM)

Excerpt:

Opponents of the public option maintain that Canadian-style health care would entail rationing, caps on care, bureaucratic interference in medical decision-making and even “death panels” deciding when the ill become too expensive to save. Most Canadians believe this is a gross exaggeration of reality. But then how to characterize Ontario’s decision to cut off funding for colorectal cancer patients taking a life-prolonging drug, in order to save $9-million a year?

[…]Ontario Health Minister David Caplan rejected the suggestion that the cap on treatment was a financial decision alone, arguing it was based on clinical evidence. But it’s easy to reach the conclusion that the province decided nine extra months of life for a dying patient wasn’t worth the money. Which is pretty much the kind of decision a “death panel” would be confronted with.

There are ways to reduce the costs of health care while retaining freedom of choice in a capitalist system. Health care is so highly-regulated already that we are not even trying a fully capitalist system, like the one in Switzerland that I wrote about earlier.

Further study

Learn more about health care policy from my previous posts on health care:

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Commentary

MUST-READ: A medical doctor explains how Obamacare fails patients

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This American Thinker essay is awesome, and was sent to me by ECM.

The author gives the physician’s perspective on Obama’s government-run health care plan.

First, Pollard explains that Medicare is not providing good service now because it is rationing care.

Excerpt:

I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases the antibiotic needed for the eradication of the infection was not on the approved Medicaid list.

Each time I was told to fax Medicaid for the approval forms, which I did. Within 48 hours the form came back to me which was sent in immediately via fax, and I was told that I would have my answer in 10 days. Of course by then each child would have been blind in the eye.

Each time the request came back denied. All three times I personally provided the antibiotic for each patient which was not on the Medicaid approved list. Get the point — rationing of care.

Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post cataract surgery. By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time.

Again, extreme rationing. Solution: I have a foundation here in Atlanta supported 100% by private funds which supplies all of these contact lenses for my Medicaid and illegal immigrants children for free. Again, waiting for the government would be disastrous.

That is what happens when the government is the single-payer for treatment. Long delays, waiting lists, rationing. The solutions are all with the private free market, not with the government.

The rest of the article contains other examples of problems with government-run health care:

  • how Sweden’s government-run health care system puts people on waiting lists
  • how Medicare is slow to reimburse doctors for services performed
  • how government-run care in the military is rationed
  • how the British government-run system denies care to the elderly
  • the consequences of billing the government for care instead of paying your doctor what they ask for
  • the real story about whether the uninsured receive care

But there is one point you may never have heard before, and I want to cite this last point in full.

In the free market, doctors compete with other doctors to provide the best care for the patient at the lowest price. But the government is run by politically correct social engineers who make rules based on what seems fair to them. And often, what seems fair to them is racial discrimination and gender-discrimination in the form of affirmative action programs. And that has consequences for you.

Excerpt:

One last thing: with this new healthcare plan there will be a tremendous shortage of physicians. It has been estimated that approximately 5% of the current physician work force will quit under this new system. Also it is estimated that another 5% shortage will occur because of the decreased number of men and women wanting to go into medicine. At the present time the US government has mandated gender equity in admissions to medical schools .That means that for the past 15 years that somewhere between 49 and 51% of each entering class are females. This is true of private schools also, because all private schools receive federal funding.

The average career of a woman in medicine now is only 8-10 years and the average work week for a female in medicine is only 3-4 days. I have now trained 35 fellows in pediatric ophthalmology. Hands down the best was a female that I trained 4 years ago — she was head and heels above all others I have trained. She now practices only 3 days a week.

Don’t let the government run your health care plan, do it yourself. There are other ways to reduce costs that do not involve rationing of care.