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24 October 2009

Changes for Doctors and Patients Under ObamaCare

The House bill 3200HR is one of the bills being folded together in some mysterious way in Congress.  The Senate has some Democrat Senators and Rahm Emanuel huddled behind closed and locked doors meshing together the Health Committee bill and the Finance Committee bill, which seems to have become 1500 pages long suddenly after the Finance Committee voted on a conceptual plan a bit under 300 pages long.  We do not know precisely what the ill-chosen provisions of the final passed bill will be, but the way everything is being rushed and so much is being hidden, we have to evaluate as much as we can from the available information, or we will be caught flat-footed when the final version is rushed blindly through Congress.

Here are a few provisions of HR 3200 we had best take note of:
  • Doctors are in the public option unless they opt out.  There is no mechanism for opting out.  The Secretary of Health and Human Services will set up a mechanism someday and it may include penalties, fines, taxes, and who knows what other disincentives.  In effect, the plan is to make doctors slaves who may then have some onerous option to buy their freedom, their manumission.
  • The paperwork required of doctors has been increasing rapidly over the last 15 years.  This bill will increase it much more, cutting down on patient time, attendance at seminars and on post-graduate education.  They will have to document all interactions with the many new federal bureaucracies to be set up, as well as the greatly expanded ones.  They will have to document all referrals, determine if there are fraud risks, and continually update quality assessments.  They will be bored to death!
  • The expanded patient records will include copious financial records, medical data, mental health evaluations, and such things as any sexually transmitted infectious diseases.  This data will be available to huge numbers of medical people and to many bureaucrats.  Imagine what the Democrats will do with this information on a Republican running for public office?  Apparently, they will use such information on that Republican's entire family, if we can extrapolate from Sarah Palin's case.
  • If patient's must be readmitted to a hospital after being released, there are fines.  Those with chronic diseases, the disabled, and the elderly are most likely to be readmitted.  Doctors and hospitals will become reluctant to treat such people because they inherently bring with them an increased likelihood of fines due to readmission.  There will be attempts to transfer such patients to other facilities.
  • End-of-life counseling will be required as part of the regular medical practice.  The government will train and approve the counselors.  It will provide the films, brochures, and the data to be given to the patients.  It is expected that this advice will be for them to forgo more than ordinary medical treatments and play upon their guilt in being a burden.  The health czar, Ezekiel Emanuel, believes doctors are obsessed with the Hippocratic Oath.  He serves on an advisory panel for the Hastings Center which states that patients should reject ordinary and extraordinary care and accept death.

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