red states rule
10-13-2009, 08:43 AM
It is clear Dems will ration care under Obamacare. Now it is openly in the bill Dems will vote on in the Senate
The 'kill granny' bill
Senate bid to sock elder-careBy BETSY MCCAUGHEY
Last Updated: 11:18 AM, October 5, 2009
Posted: 1:05 AM, October 5, 2009
As the health-reform bills move through Congress, the prognosis for Medicare patients gets worse and worse.
The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus) robs the elderly to cover the uninsured -- like snatching purses from little old ladies. The House bills already cut future funding for Medicare by $500 billion over the next decade. The Baucus bill would slash a similar amount, just when 30 percent more people enter the program as baby boomers turn 65.
The Baucus bill also puts new limits on what doctors can do for patients in Medicare:
A "race to the bottom" provision (p. 102 of the revised chairman's mark) would take effect each year for the next five years. The provision penalizes doctors who end up in the 90th percentile or above on the cost of what they use to treat their patients, compared with national averages. The intent is to force down the cost of care, year by year. Yet this blunt instrument can't determine which care is actually wasteful -- it will punish doctors for treating high cost patients with complex conditions. Inevitably, it will lower the quality of care.
* Even more devastating is the amendment Sen. Maria Cantwell (D-Wash.) got inserted into the bill (revised chairman's mark, pp. 102-3). It gives the Secretary of Health and Human Services the power to define quality, cost-effective care for each medical condition and penalize doctors who spend more on their patients.
The law establishing Medicare in 1965 barred the federal government from interfering in doctors' treatment decisions. Slowly, Medicare regulations have begun unraveling that protection. Now the Cantwell amendment finishes the job.
This is the most extreme change to Medicare ever. Dr. David McKalip, a Florida neurosurgeon and a board member of the Florida Medical Association, predicts: "The only doctors left in Medicare will be those willing to ration care and practice cookbook medicine."
It's reasonable for Medicare administrators to strive to get value for dollars spent. In recent years, Medicare has taken a slow, tight-fisted (and sometimes arbitrary) approach to paying for new drugs or medical devices. But Cantwell aims directly at doctors' decisions.
That's not surprising. President Obama and his advisers vilify doctors for over-treating patients. Dr. Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel and a key Obama health-care adviser, argues that the Hippocratic Oath is largely to blame for the "overuse" of medical care.
http://www.nypost.com/p/news/opinion/opedcolumnists/the_kill_granny_bill_MenNO0aNV8CLUTDwbm5PUN
The 'kill granny' bill
Senate bid to sock elder-careBy BETSY MCCAUGHEY
Last Updated: 11:18 AM, October 5, 2009
Posted: 1:05 AM, October 5, 2009
As the health-reform bills move through Congress, the prognosis for Medicare patients gets worse and worse.
The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus) robs the elderly to cover the uninsured -- like snatching purses from little old ladies. The House bills already cut future funding for Medicare by $500 billion over the next decade. The Baucus bill would slash a similar amount, just when 30 percent more people enter the program as baby boomers turn 65.
The Baucus bill also puts new limits on what doctors can do for patients in Medicare:
A "race to the bottom" provision (p. 102 of the revised chairman's mark) would take effect each year for the next five years. The provision penalizes doctors who end up in the 90th percentile or above on the cost of what they use to treat their patients, compared with national averages. The intent is to force down the cost of care, year by year. Yet this blunt instrument can't determine which care is actually wasteful -- it will punish doctors for treating high cost patients with complex conditions. Inevitably, it will lower the quality of care.
* Even more devastating is the amendment Sen. Maria Cantwell (D-Wash.) got inserted into the bill (revised chairman's mark, pp. 102-3). It gives the Secretary of Health and Human Services the power to define quality, cost-effective care for each medical condition and penalize doctors who spend more on their patients.
The law establishing Medicare in 1965 barred the federal government from interfering in doctors' treatment decisions. Slowly, Medicare regulations have begun unraveling that protection. Now the Cantwell amendment finishes the job.
This is the most extreme change to Medicare ever. Dr. David McKalip, a Florida neurosurgeon and a board member of the Florida Medical Association, predicts: "The only doctors left in Medicare will be those willing to ration care and practice cookbook medicine."
It's reasonable for Medicare administrators to strive to get value for dollars spent. In recent years, Medicare has taken a slow, tight-fisted (and sometimes arbitrary) approach to paying for new drugs or medical devices. But Cantwell aims directly at doctors' decisions.
That's not surprising. President Obama and his advisers vilify doctors for over-treating patients. Dr. Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel and a key Obama health-care adviser, argues that the Hippocratic Oath is largely to blame for the "overuse" of medical care.
http://www.nypost.com/p/news/opinion/opedcolumnists/the_kill_granny_bill_MenNO0aNV8CLUTDwbm5PUN