And They Say There is No Rationing

[GonnaFlyNow]

And they say there is no rationing:

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.

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.


EDITORIAL: Death panels by proxy - Washington Times

 

[Winter_123]

One of the painful ironies of the whole thing is that people are influenced by Michael Moore/Barack Obama types who say that we need government run systems to get away from the ugly rationing of managed care plans where doctors are rewarded for not providing care.

As some pundit said a while back, if you liked Michael Moore's movie about the horrors of our current medical care system, wait until someone comes out with one about the government run plans in a few years.

The other thing that really puts the docs in a bind is that Mr. Obama says they will be managed on outcomes. Now we are also saying they will be managed on cost containment. So do you want to provide the level of intervention that keeps the patient alive longer or the one that holds costs down?

Of course a lot of medical care is a complete waste but it is up to the docs now to fight that out with the government. Like the insurance carriers, and the pharms, they layed low and tried to play ball with the government because they thought they would get more clients. Now, it appears that they will get more clients but be paid less and regulated more. duh. Smarten up.