Tuesday, September 15, 2009

Medicare and Medicaid plan to ration heath care

There is a big debate about whether or not a universal healthcare plan such as Obama is proposing would result in the government deciding to ration health care services. To me it's obvious that a government takeover of healthcare would result in rationing: how can you make something universally available at a fixed cost without shortages developing? If you don't allow prices to rise, you will have to cut back on services rendered.

Well, it's already happening, as noted in this article: "Medicare facing cancer, cardiac care cuts." Excerpts:

If enacted as scheduled on Jan. 1, 2010, policy changes recommended by the federal Centers for Medicare and Medicaid Services (CMS) -- the government's insurer for the elderly and disabled -- will severely cut current Medicare reimbursements to cardiologists and oncologists for critical care services that are provided to patients in physicians' offices or other out-of-hospital setting, such as chemotherapy to treat cancer, and various cardiac procedures to monitor and treat heart disease, such as nuclear imaging and heart catheterization.

These cuts will force cardiologists and oncologists to limit care to their Medicare patients, withdraw from treating Medicare patients altogether or require their patients to pay more out of pocket to make up the difference in the cost of these services.

The changes certainly will force the closing of outreach clinics in rural areas, leaving many people without easily accessible cardiac or cancer care.

The policymakers at CMS, who base their decisions on numbers and statistics, are unilaterally and dramatically changing the delivery of heart and cancer care by proclaiming that care for heart disease and cancer is too costly, while treatment for other diseases has greater value.

HT: Glenn Reynolds


Adam said...

I think you have to be careful with the conclusions you draw from the quoted text. It could be, for example, that CMS no longer considers the named procedures to be appropriate of administration in out-of-hospital settings for patient care reasons. It is also possible that the revenue contribution to the clinic is marginal and will not force a closing. Not without dispute, CMS has always distinguished between hospital based services and office services.

Scott Grannis said...

I'm not drawing any conclusions from the quoted text of the article, but it is clear that CMS plans to make significant cuts in the funding for certain procedures and services, is it not? This is the government deciding how to spend healthcare funds, not the patient, and they propose a cut in funding. Obama's plan calls for hundreds of billions in cuts on Medicare and Medicaid spending, though he claims they are not cuts but rather reductions in inefficiency. Hmmm

Anonymous said...

This is cool :)

chai said...

In addition to the planned rationing (see Obama health advisor Ezekiel Emanuel's extensive writings on this), consider the following IBD poll:


"45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul"

As a physician who speaks to many other physicians, I can tell you how true this is.

So rationing is going to happen in many ways.

Many private offices and clinics will shut down for reason of loss of profit margin, as well as stifling government regulations.

If you thought waiting lines for your doctor are long now, you ain't seen nothing yet.

Right now, there is virtually no waiting to get necessary lab tests, diagnostic imaging tests such as CT, MRI, PET scan, and treatment etc. This will change dramatically.

Case in Point: Mammography exams in the U.S. Government regulations and reimbursement limitations have made this a loss leader in medical imaging. The result? The average waiting times for screening mammography in New York- 6 months.

You have seen the future and it's not pretty.

I'm from the Government and I'm here to help..... We'll give you more for less... Just give us your IRS returns and your bank account numbers.. and we'll transfer monies into your accounts... Really.

MW said...

"There is a big debate about whether or not a universal healthcare plan such as Obama is proposing would result in the government deciding to ration health care services."

When I took my first economics class, age 14, we learnt that economics is about the allocation of scarce resources. Either the govt or the mkt can allocate resources; the choice is simply which. To deny that there will be any rationing is nonsense. Whither the economic 'dream team' to stand up to this drivel? I thought there was an economic briefing each morning?!

Scott Grannis said...

chai: thanks for your comment and the reference to the article. I happened to find it myself this morning before I got around to checking comments.

Scott Grannis said...

MW: You really have to wonder about people like Christina Romer, an excellent economist who has done good work, but now signs on to the economic drivel that Obama is spouting. Is there no one on his team that is willing to challenge his lack of knowledge of basic economics?