Smells like rationing spirit

posted at 2:21 pm on September 2, 2009 by Ed Morrissey

The supporters of ObamaCare insist that government control of health care will not lead to rationing.  However, a report late last week from Bloomberg gives a clearer indication of the kind of power ObamaCare will put into the hands of bureaucrats, and how they will control access to health care through the government checkbook.  Medicare has cut $1.4 billion in payments to cardiologists and oncologists in order to ration resources towards family-practice physicians (via Doug Ross):

While President Barack Obama and members of Congress have spent August debating health insurance and medical costs at public forums, specialists are waging what one advocate calls a “tooth and nail” fight against a separate initiative to boost the pay of family doctors, and cut fees for cardiologists and oncologists. The specialists, in newspaper columns and meetings with lawmakers, say patients will lose access to life-saving care, from pacemakers to chemotherapy.

The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama’s broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief. …

The cuts could have the unintended consequence of rationing care, especially in rural regions with a large number of Medicare patients, doctors said. In other areas, specialists may decide to pull out of Medicare, or ask patients to make up the difference with higher out-of-pocket payments, said Alfred Bove, president of the American College of Cardiology.

“A fair number of cardiologists are looking at the accounting and saying ‘we can’t afford it,’” Bove said in a telephone interview.

How will this affect costs for those who need oncological and cardio care?  It will force patients into hospitals rather than clinics:

Some oncologists in rural areas may stop offering chemotherapy in the office, forcing patients to travel to more- distant hospitals, said Allen S. Lichter, 63, CEO of the 27,000- member American Society of Clinical Oncology in Alexandria, Virginia.

That is exactly how rationing will take place in a government-run system.  Politicians will decide on priorities and adjust compensation to promote their engineering of the health-care sector.  Lower compensation will drive specialists out of the system, especially in disciplines not fortunate enough to have political support, just as happens in Oregon now.

What’s the result?  Fewer providers, higher costs, and more pressure on hospitals for treatment rather than clinics, where treatments are both more efficient and available.  We’re already seeing this in Medicare as providers stop taking new clients in the program.  The compensation supposedly controls costs, but it only controls pricing, and the costs of providing service outstrip the compensation.  Under those circumstances, providers have to either stop taking Medicare patients or fold.

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Take a bite of my DeathCake, it’s good.

faraway on September 2, 2009 at 2:27 PM

I thought it was the salmon mousse…!

Liberty or Death on September 2, 2009 at 4:18 PM

Hey Senior Citizens and Independent Voters? How are you feeling NOW?! Are you going to do something about this?! You’re the reason we’re here… DO SOMETHING!!

Khun Joe on September 2, 2009 at 4:19 PM

I thought health care was supposed to make us feel healthy, and good inside…not dismal and depressed.

In the mind of the Communist, I suppose it’s not what you do feel but how you should feel, and not if something doesn’t work, but rather that it should work.

Dr. ZhivBlago on September 2, 2009 at 4:20 PM

It’s almost unbelievable to me that Medicare would start with cardiologists and oncologists. Do you really want your dad’s general family physician handling his heart medication, or recommending whether or not he needs surgery, chemo, or radiation for cancer? Of course not, you want a specialist for those life-threatening conditions.

It’s all well and good to encourage more doctors to go into general family practice, but the fact is that the longer we live, the more cancer and heart disease cases will arise and we need specialists in those areas.

rockmom on September 2, 2009 at 4:52 PM

Take a bite of my DeathCake, it’s good.

faraway on September 2, 2009 at 2:27 PM

But I like yellow cake with chocolate frosting. Can’t I have that instead?

Yakko77 on September 2, 2009 at 9:51 PM

From the OMB (dollars in billions). Link:

Years 2006 2007 2008 2009 2010 2011 2012

Medicare 325 367 386 409 434 475 482
Medicaid and SCHIP 186 198 209 223 239 257 277

Bottom line: a $1.4 billion cut in Medicare in FY 2010 would be a reduction in the growth of Medicare, just like Bush’s proposal last year, not an absolute cut.

The cost pressures were no different under Bush’s proposal than under Obama’s.

Jimbo3 on September 2, 2009 at 10:05 PM