Max and the Bean Counters
The Baucus bill under debate in Congress this week is being touted as the compromise to save health care ‘reform’. But that’s a misrepresentation.
Yes, there are death panels. Its members won’t even know whose deaths they are causing. But under the health care bill sponsored by Senate Finance Committee Chairman Max Baucus, Montana Democrat, death panels will indeed exist – oh so cleverly disguised as accountants.
It’s in the bill.
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…
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.
Hentoff caught that in the Baucus proposal, and wonders…why so little attention on this?!
“In the Senate Finance Committee’s health-care bill, there is a dangerous provision that could deny crucial health treatments for Medicare patients,” he writes in a new column posted at WorldNetDaily.
“During the continuous, extensive coverage of this proposed legislation, there has been only very limited mention – and none I’ve seen in the mainstream press – of” the provision, he writes.
Pay attention to this…
Hentoff notes that a section in the Baucus bill seems to be an exception to what he terms as an “iron mandate” for reducing medical-care costs that is not related to quality of care but aimed at reducing the national debt.
“There is a section (page 80, the Chairman’s Mark) that gives Kathleen Sebelius, secretary of health and human services, permission to adjust these strictures for ‘those physicians who tend to serve less healthy individuals who may require more intensive interventions,'” the pro-life columnist points out.
“But what is submerged in here is the cold fact that even if a Medicare doctor does apply this permission in treating certain patients, as he considers necessary, the pressures will continue – with regard to his entire cumulative roster of other Medicare patients – to keep very much in mind that he or she may still be in peril of winding up at the end of a year in the punishable top 10 percent of annual Medicare costs per patient,” he says…
Even if the “insidious” provision is eliminated from the Baucus bill, Hentoff says ” its actual existence is a further warning to all of us to pay very close attention to all the health-care ‘reform’ bills before any of them becomes law.”
Hentoff says there are many losers in this bill.
National Right to Life points out a whole class of them besides Medicare patients.
“The bill contains provisions that would send massive federal subsidies directly to both private insurance plans and government-chartered cooperatives that pay for elective abortion,” Douglas Johnson of the National Right to Life Committee previously explained.
“In addition, the Baucus bill requires that a specific charge must be included in the premiums paid by those who enroll in such subsidized plans, of at least ‘$1 per enrollee, per month,’ which amounts to a surcharge specifically for elective abortions,” he said. “The Baucus bill provides $6 billion in federal funds for the establishment of health insurance cooperatives, without any limitation on the use of these funds to pay for abortions or to subsidize plans that pay for elective abortions.”…
Looking at other changes to the Baucus bill under the modification, on the down side, the revised Baucus bill also incorporates an amendment pro-abortion Sen. Debbie Stabenow planned to offer this week that would expand eligibility for family planning coverage under Medicaid and establish school-based health centers.
The centers have long been controversial in the sense that they could provide drugs that could cause abortions to girls without parental knowledge or consent or refer teens for abortions.
So then…..this is a lose/lose/lose situation.
Which makes it imperative that an active and engaged public learns what Congress is doing, and lets the representatives know what members of the republic want done. Which….requires Congress to inform the public, and they’ve been squabbling over even that.
For his part, President Obama – an advocate of transparency measures during his time in the Senate – made a pledge to post bills on the White House Web site for comment at least five days before he signs them. But he has so far failed to live up to the promise, instead posting links to Congress’ Web site, where visitors must sort through numerous versions of legislation.
Daunting as that is, the people are currently doing a better job of it than our elected representatives.
Keeping the opposition in the dark while you move in fast is not the way to run our republic. Stealth is a tactic that should be reserved to America’s military, for use against our enemies. It shouldn’t be used by America’s politicians against our own people.
