Tag Archives: Ration

How Obama’s public option would ration specialized care

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:

Share

One in six patients misdiagnosed by NHS

Story from the Telegraph. (H/T Secondhand Smoke via ECM)

Excerpt:

As many as one in six patients treated in NHS hospitals and GPs’ surgeries is being misdiagnosed, experts have warned. Doctors were making mistakes in up to 15 per cent of cases because they were too quick to judge patients’ symptoms, they said, while others were reluctant to ask more senior colleagues for help. While in most cases the misdiagnosis did not result in the patient suffering serious harm, a sizeable number of the millions of NHS patients were likely to suffer significant health problems as a result, according to figures. It was said that the number of misdiagnoses was “just the tip of the iceberg”, with many people still reluctant to report mistakes by their doctors.

When the people providing the service are not being paid by the customer based on the quality of service provided, what incentive is there for the service provider to provide good service?

Take the money out of the hands of bureaucrats and medical insurance companies, put it back in the hands of the patient and provide the patient with information about prices and past patient outcomes. Then de-regulate the industry to increase new entrants and increase competition. Choice and competition. That is how you reduce costs and retain individual liberty.

Share

Paul Krugman says that public option would lead to single-payer health care

Video from Verum Serum.

Morgen writes:

And so here, once again, is our gregarious friend from the NY Times, Paul Krugman, speaking about healthcare reform. This is a segment from an interview which aired on Democracy Now! in October 2007.

[…]Paul Krugman is a well-known economist who writes regularly for the NY Times. The fact that almost 2 years ago Krugman so willingly conceded information that conservatives have had to dig to uncover is a damning indictment of the bias and/or incompetence of the media. (And Krugman made this same point in a February 2007 NY Times column.)

The public option has now been the central controversy of healthcare reform for what…at least 3 months? And yet up until very recently, did anyone in the MSM think of looking into or reporting on how the idea came about? And whether conservative assertions that it is a trojan horse for single payer had any merit? Does it really take bloggers doing research in their spare time to discover and document information of such national importance?

Verum Serum rocks!