The Right Prescription
The Absolutely Worst Bill Ever
The Obama/Pelosi House bill is a cruel perversion.
“The Worst Bill Ever.” That is the title the always calm and rational Wall Street Journal put on its editorial on November 1 about the government health care takeover bill that passed the House last week on virtually a party line vote, 220-215. But even this label doesn’t fully communicate the outright assault on the American people involved in this legislation. The bill is a serious threat not only to your freedom and prosperity, but to your very life as well.
That is because at the heart of this bill is a cruel perversion. The bill labors mightily (though it actually fails) to expand insurance coverage to everyone (taking the most expensive route possible). But then it is devoted to taking away the very health care that you may need to save your life, or the life of a loved one.
Pelosi’s Death Panels
The bill would create 118 new federal boards, bureaucracies, commissions, and programs, which as a group have the power to ration and deny you health care. These are the Pelosi death panels. They include the Health Choices Administration, the Health Benefits Advisory Committee, the Health Insurance Exchange, the Public Health Insurance Option, the Center for Comparative Effectiveness Research, the Comparative Effectiveness Research Commission, the Accountable Care Organization Pilot Program, the Community Based Medical Home Pilot Program, the Independent Patient Centered Medical Home Pilot Program, and many others.
One of the ways that health rationing would be carried out is through so-called “Comparative Effectiveness,” where national health care bureaucracies will decide what health care treatments, procedures, therapies and drugs work best, and which don’t. You would think that is what your doctor is for, using his medical knowledge and direct personal observation of your condition and health history to prescribe what is best for you. But liberal Democrats insist that faraway federal bureaucrats who don’t know anything about you will know exactly what health care will work best, in all cases. The House bill says that the decisions of federal bureaucrats on comparative effectiveness “will be delivered to doctors electronically to guide their use of medical items and services,” as Betsy McCaughey reports in the Wall Street Journal on November 7. If doctors don’t take the hint, and use their own judgment as to your care instead, they will be penalized in their compensation under Pay for Performance.
That policy was explained in a June report from President Obama’s Council of Economic Advisors (CEA), entitled “The Economic Case for Health Care Reform.” That report says that 30% of health care in America is waste, and wise government bureaucrats are going to identify exactly whose health care is waste and cut it out. Another policy for accomplishing this is called “Cost Effectiveness,” where wise government bureaucrats will decide whether your health care is worth the cost to society. The House health bill creates the bureaucracies with the power and authority to carry out these policies.
But it is far worse even than this. Through the Public Option, the Medicare cuts discussed below, and new rules and regulations imposed on compensation for doctors, hospitals, and other health providers more generally, the resources that sustain our highly advanced, sophisticated, cutting edge, high tech medical system will be sharply constricted. The incentives for investment in new innovations, advanced medical equipment, new miracle cure drugs, and first-rate hospital and clinic facilities will be decimated. Just when the rapid advancement of science and technology is opening up new vistas to counter disease, suffering, and death, self-congratulatory politicians and bureaucrats are stomping in and shutting it down.
In the future, when you or a loved one is struck with cancer, or heart disease, or your premature baby is struggling for life, the surgery, the machine, the pill that could have saved a life, will not be there. When the doctors come to tell you that there is nothing they can do, they are not going to explain whether that is due to medical science, or to politics and bureaucracy, and you will not know. But more and more likely over time, you will be a victim of the declining American standard of living imposed by ideological extremists, as reflected in part in the loss of the best health care possible.
Exactly to the contrary, our public policy should be focused on maximizing the advancement of health care in this new age of modern science by removing government burdens and barriers. We do need to control costs, but by introducing market incentives for patients, doctors and hospitals, so they can be in charge and make appropriate decisions, free of financially interested third party bureaucracies. It’s called Patient Power, the true alternative to what Washington is doing now. Jim Pinkerton has been brilliantly making this case for months now on his Serious Medicine Strategy blog, though the argument goes all the way back to John Goodman’s book, Patient Power.
But the left-wing extremists currently in complete control of Washington have no understanding of any of this. They are wedded, emotionally and religiously, to outdated ideological crusades of 100 years ago. This is a time of great challenge for the American people, like World War II, the Civil War, or the Revolutionary War. If you are not involved in the solution, then you are not only letting down America, but your family, and yourself.
Medicare Cuts
One confusion arising from the House bill is that its provisions are phased in over several years. Over the first 10 years of full operation, the House bill actually cuts Medicare by $800 billion, as scored by CBO. The cuts for Medicare Advantage plans will be close to $200 billion, and despite President Obama’s phony shtick that if you like your health plan you can keep it, the Administration itself estimates that 8 million seniors will lose their Medicare Advantage plan as a result, 73% of those with such plans.
This is the beginning of health care rationing for seniors, as the payments to their doctors and hospitals for the care that currently maintains their health will be slashed back. In addition, as Betsy McCaughey explains in the Journal, the House bill
moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what’s called a “medical home.” The medical home is this decade’s version of HMO restrictions on care. A primary care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary care provider. Medical homes begin with demonstration projects, but… HHS…is authorized to “disseminate this approach rapidly on a national basis.”
What this means is that your doctor is paid a flat monthly fee for your care, and referring you to a specialist or for a diagnostic test effectively comes out of his pocket. So if you need an MRI or a CT scan to see if you have cancer, or to check if that pain in your chest is due to clogged arteries, or if you need to see a specialist to treat cancer or heart disease, the doctor has a financial interest to delay or deny it. Financially, if you are actually this sick, he will be better off if you die sooner rather than later. That is the result of the perverted, inverse incentives the House health bill creates for medical providers.
About the Author
Peter Ferrara is Director of Entitlement and Budget Policy at the Heartland Institute, General Counsel of the American Civil Rights Union, Senior Fellow at the National Center for Policy Analysis, and Senior Policy Advisor on Entitlements and Budget Policy at the National Tax Limitation Foundation. He served in the White House Office of Policy Development under President Reagan, and as Associate Deputy Attorney General of the United States under President George H.W. Bush.
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Pingback| 11.11.09 @ 7:00AM
Twitter Trackbacks for The American Spectator : The Absolutely Worst Bill Ever [spec links to this page. Here’s an excerpt:
Viktorich | 11.11.09 @ 7:21AM
For what you so don't like Obama?
ggoblue| 11.11.09 @ 8:09AM
the worst part of it all is this: all treatments no matter how expensive will be provided to comrade party members...if you arent a good little democrat you will be allowed to die. thats the monstrosity being created.
alyeska| 11.13.09 @ 1:10AM
hmmmm, apparently the republicans don't mind curtailing womens' health care options, while being very generous with their own female comrade party members....
GOP bigwigs’ health insurance covers elective abortions:
"We believe in the sanctity of life, and the Stupak-Pitts Amendment addresses a moral issue of the utmost concern," House GOP leaders John Boehner (R-Ohio), Eric Cantor (R-Va.) and Mike Pence (R-Ind.) said in a statement after the vote. "It will limit abortion in the United States. Because of this, while we strongly and deeply oppose the underlying bill, we decided to stand with Life and support Stupak-Pitts."
Still, the RNC chose not to opt out of abortion coverage, Cigna representatives told Politico.
RNC spokeswoman Gail Gitcho reportedly said the policy pre-dates the tenure of current RNC Chairman Michael Steele.
"The current policy has been in effect since 1991," she said, "and we are taking steps to address the issue."
they've had since 1991 to address this issue? i sense a soupcon of hypocrisy here :)
Old Soldier| 11.11.09 @ 8:18AM
Wait until some committee of bureaucrats tells a father that his kids don’t rate treatment and should just die. When he (justifiably) murders the lot of them, the program will include armed guards, secret committees, and gun seizures. These are inevitable consequences.
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Ned| 11.11.09 @ 10:40AM
Old Soldier, you are correct, except the state run media will never report the story, but at least the father will get mental health counseling, so long as he belongs to a registered victims group.
tj| 11.11.09 @ 11:03AM
REPARATIONS ANYONE!!! Healthcare for me, but not for thee....if is not good enough for this administration it is not good enough for me. I will not let you take over my healthcare or my freedom Vote em out 2010/2012. People wake up! Stand up and fight this evil!!
Walter| 11.11.09 @ 12:56PM
I put a lot of blame for this on the Republican politicians who controlled Congress and the White House for so long and who determined who will run under the "R" banner.
It was they who opened the door to a Democratic takeover of government when they abused the power that they had been given and totally dispensed with the mandates that they had been given to steer the country in a conservative direction. They've put us all at risk with their foolish beliefs in politics over principles. They became Democrat-lites (except they were worse at it), were thrown out of office and left the door open for whatever despotism would follow.
I hope that history will record that it was their dereliction of duty and lack of honor that bordered on the treasonous in exposing the country to the dangers that it now faces.
Rmm| 11.11.09 @ 10:15PM
My wife and I have had this same conversation, months ago. You are absolutely correct about Bush & Co. opening this up for the radical Left to pour into the vacuum. It is enough to piss-off the Good Humor man.
Stan Redmond| 11.11.09 @ 4:45PM
Imagine how good the care you will get as a white male? After budgets are made for popular medical care like women's medical issues, minority medical issues, gay medical issues, transgender medical issues, children's medical issues, and political club medical issues, there's nothing left for you white males. The British NHS spends more money on women than men. Do you think democrats are going to allow equal funding for regular middle American folks and inner city minority groups? HECK NO!!!
alyeska| 11.13.09 @ 1:34AM
oh no, they're going to cut off your viagra -- cold!
jri500| 11.14.09 @ 6:06AM
Oh crawl back in your hole and stop wasting everyone's time with your brainless, moronic posts. You are obviously a mental-defective, liberal democrat loser and a gutless, America-hating Obamist coward.
hunter| 11.11.09 @ 6:22PM
call, phone,write often, and ask your relatives friends and neighbors to do the same. I agree wholeheartly with Walter and Stan, previous comments. This country is under attack, by foreign enemies, from within.
Michael Lee | 11.11.09 @ 8:39PM
I've been a resident of British Columbia for 9 years and the medical system here has treated me very well. But I am very concerned about Obamacare. One of the best things about living in southern BC is the short trip to the US if I get unhappy with waiting in line here. That option would be in serious jeopardy when NICE comes to the US.
alyeska| 11.13.09 @ 1:37AM
well, have you ever had to cross the border to avoid waiting in line?
you need to move back to the us -- canada doesn't need people like you, using their health care services while trashing them at the same time.
go home!
jri500| 11.14.09 @ 6:08AM
Why don't YOU to live with your daddy Fidel in Cuba. Then you can enjoy "the finest heathcare system in the world", you scumbag.
Jennifer Scott ARNP, FNP-BC | 11.11.09 @ 10:50PM
I find it a little insulting that you think that patients "settle" for a NP. My patients prefer me to other physicians and will tell you so. I am a great health care provider with patients who actually come back and do the necessary maintenance to remain as healthy as they can be. I serve in a rural community who is having a very hard time attracting physicians. I find it appalling that you would think that any health care provider would keep a patient from appropriate testing in order to line their own pockets. If they are doing so, they need to be run out of health care. I take care of patients because it's a calling and not just because it pays well. I am curious to see if you have ever seen a nurse practitioner in action before you make snap judgments about the quality of our care.
Walter| 11.12.09 @ 11:09AM
Jennifer,
Thank you for being the type of NP that we all hope will be caring for us when we need you to once a lot of our doctors have wised up and left medicine in disgust with low reimbursements (their reward for 25 years of expensive and grueling medical training) and bureaucratic bungling.
I hope that you can keep your heart in your calling and not become hard and cynical as the work load increases, your face time with patients decreases and you see your compensation and quality of life falling based on what some bureaucrat (not your patient) thinks you deserve to be paid. I hope that you will keep your motivation (after all, we are all depending on it) when you discover that the money to be made in health care has shifted from the providers to the deciders.
I have seen NPs and they are wonderful, as I’m sure that you are. However, in a changed health care environment, with increasing stress on our medical providers, it may be a totally different work environment.
Jennifer Scott ARNP, FNP-BC | 11.22.09 @ 12:32AM
Walter,
Unfortunately, I already am seeing the problems with lower reimbursements by the health insurance policies. They are the real reason why health care is in shambles. I don't like the idea that they decide how health care providers do their jobs and make the premiums so high that regular people cannot afford coverage. Most of my patients do not have insurance and cannot have the testing they need in order to properly confirm what I already suspect is going on so that I can get them treated. It's frustrating watching patients wither away because they have to choose between food or proper treatments.
Roy| 11.13.09 @ 1:56AM
I agree with this. NP's can probably do 90% of what a physician does and in many cases better. Similarly, in a hospital setting, nurses are overworked because they are used for all kinds of tasks that do not require three years of nursing school to learn.
I don't know the exact reason, but I'm guessing it is John Edwards. If anything happens to a patient and they find out that an NP and not a physician made some decision, or a nurse tech and not a nurse brought them their food, then John Edwards, Johnnie Cochrane, John Grisham, and a million other baying leftist demagogues will sue the hospital out of existence.
So, since the government has created the problem the government will now "solve" it through rationing and the exemption of itself from lawsuits. And freedom loses once again.
Jennifer Scott ARNP, FNP-BC | 11.22.09 @ 12:36AM
Roy,
Thanks for the vote of confidence in regards to NP care. The reason nurses are overworked in the hospital is because of litigation issues with lawsuits. Too often we have to take care of the paperwork instead of the patient. (As a provider, it's true too.)
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marianne| 11.13.09 @ 10:55PM
So they are going to deny medicine and certain tests to Seniors and give healthcare to illegal immigrants. I guess George Soros will open up his 'Project on Death in America' again when this health plan is voted in.
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