Baucus Health Care Has Built-in Rationing...But Obama Starts Rationing NOW

No it isn't death panels, but it might as well be, two moves coming from our Democratic-party-controlled government ration needed health care treatment one in the Baucus version of the Obamacare bill, the other an executive order by the POTUS.

The Baucus bill has a provision which penalizes the doctors who prescribe the most tests/procedures. Those in the top 10% of prescribing doctors will get fined five percent of the money they get back from the government. The purpose of this procedure is to provide incentive to the doctors to stop giving life-saving procedures.

Not wanting to wait for the bill, President Obama signed an order cutting the money going to fund procedures such as echocardiograms and catheterizations (slashed by 42% and 24%, respectively)

Suppose the doctors that are ordering the most tests are the specialists. Maybe the only tests that can detect a serious medical condition is expensive. Are these specialists just suppose to stop diagnostics in order to keep from being fined?

Why don't they just put a cap on how much you can be reimbursed for healthcare in a year? "Sorry bud, we couldn't stitch you back up after your open heart surgery because we ran out of money." "Here's some duct tape." "Come back and see us next fiscal year."

The more of these proposals I hear, the less I want the government involved in healthcare.

The basic tools of heart specialists—echocardiograms (stress tests) and catheterizations—are slashed by 42% and 24%, respectively.

I'm not a cardiologist, (but unfortunately I spent a lot of time with them). An echocardiogram and a stress test are not the same and had I've them both numerous times. I call a stress test "walking the plank"-they hook up electronic equipment to you and monitor your heart as you walk, and walk, and walk until you reach a target heart rate (or they stop the test because the Doc. sees a problem).By monitoring the electrical conditions they get an idea of how your heart responds under the stress of exercise.

During an echocardiogram a technician smears "slickum" on your chest and then moves a probe around. Basically, it produces a sonar image and they record the results for later interpretation by a cardiologist. They can see the general action of the heart muscles with this test.

This being a minor point, I agree with the thrust of the article.

"The Baucus bill has a provision which penalizes the doctors who prescribe the most tests/procedures. Those in the top 10% of prescribing doctors will get fined five percent of the money they get back from the government."

Brilliant! This 10 % threshold is a continuously moving scale and has two sharp and fatal edges to it:

1) A downward rationing spiral for anyone with a chronic illness.
2) Insurmountable disincentives that will starve off specialists and highly skilled physicians who treat rare or complex conditions.

Obamacare fines will force physicians to lower costs by rationing care to the most vulnerable people - who are unlucky enough to have a rare or chronic condition that needs monitoring. As the cost bar is lowered, it exposes physicians in test intensive specialties to the 10 % threshold. These physicians get whacked by government imposed fines and they have to cover the costs by charging other patients inflated prices (unlikely since there will be a fixed government payment schedule for every facet of health care), or they'll try to cover the fines and procedural costs from slim government controlled margins, or, they'll exit their specialty and refuse to see really sick people with tough cases.

Physicians who chose to invest and sacrifice the most to increase their education, knowledge, and commitment to helping desperate patients with rare or multifaceted illnesses - will be continuously punished for trying to heal the most difficult cases. Specialists and physicians who step up to the challenge of treating the hardest cases - sacrificing personal / family time, energy, and money, while putting their practice at much greater risk for litigation, will now be slapped with a big fine by Obamacare for expending greater resources to cure rare, chronic, or complex cases. This will make it unsustainable for physicians to continue in specialties that require testing, which naturally puts them in the top 10 %. This threshold keeps sliding lower as the spiral of rationing continuously lowers the bar.

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