While the various health care “reform” proposals do not literally contain a “death panel” to consign patients to the grave, any system of political rationing will trade off treatment with expense. And no one interested in his or her own medical care–or that of loved ones–really wants such decisions to be made by politicians and bureaucrats. Just look at nationalized systems for the result.
One of the most worrisome measures to emerge from the Baucus bill is the proposal to reduce reimbursements for doctors who prescribe the most expensive Medicare treatments. According to the National Right to Life Committee:
Senate Finance Committee Chairman Max Baucus’s “Mark,” released September 16 is currently being considered in committee. The bill contains a provision penalizing doctors based on how much medical treatment they direct for senior citizens on Medicare. It establishes that for at least five years (2015-2020), Medicare physicians who authorize treatments for their patients that wind up in the top 10% of per capita cost for a year will lose 5% of their total Medicare reimbursements for that year.
How to deal with exploding Medicare costs and the dilemma of “end-of-life” treatment are among the most vexing issues facing us. But this provision risks creating a direct incentive to arbitrarily reduce Medicare treatment for the sole purpose to avoid being penalized by Washington. The goal should be to eliminate unnecessary treatment and reduce the cost of unnecessarily expensive treatment. It should not be to reduce any and all treatment, come what may.
Even some supporters of the measure apparently recognize the dangers. Reports the National Right to Life Committee:
Although Senator Kent Conrad (D-ND) voted against the Kyl Amendment because he disagreed with its budget offsets (required under the committee’s rules), he earlier said, “As I try to put my feet in the shoes of a doctor, I don’t know how you separate out overutilization that is really overutilization. There is no way of knowing when you go through the year, what you are going to do at the end of the year.” He warned that the provision could come back to “haunt us” in a few years.
Sen. Conrad is right. He should reconsider his vote. In not too many years he or a family member might be the retiree being treated by a doctor worried about being penalized for authorizing too much and too much expensive treatment. This might not be a death panel per se. But the result, especially if the policy becomes permanent, could be the same–unnecessary and early death for people forced to rely on the government for medical care.
