Among the issues most commonly discussed are individuality, the rights of the individual, the limits of legitimate government, morality, history, economics, government policy, science, business, education, health care, energy, and man-made global warming evaluations. My posts are aimed at thinking, intelligent individuals, whose comments are very welcome.

"No matter how vast your knowledge or how modest, it is your own mind that has to acquire it." Ayn Rand

08 October 2009

The Cloak of Invisibility Hiding the Socialist's Death Panels

The socialists want control of the American health care system and the consequent power to make us all their dependents, their children.  They will make any argument to the People which will provide them a path to take over our health care.  They have chosen the following primary arguments:
  • Health care costs too much and it is costing more faster than the economy is growing.
  • Some Americans do not have health insurance, but everyone ought to have it.
  • People with pre-existing conditions cannot get affordable health insurance.
None of these arguments are actually good arguments when examined carefully and rationally.  But they do carry some weight with many voters.  They also influence the design of the health care policies put forth by our socialist government leadership.  I am going to primarily address the cost issue in this post.

Where do the greatest costs in our medical system occur?  It is not at the primary care level with general practitioners, internists, and family physicians.  The primary costs occur when people are really in terrible danger of dying.  They occur when someone has heart disease or cancer.  If you have heart disease, you turn to a specialist called a cardiologist.  If you have cancer, you call upon an oncologist.  These physicians are much more highly trained than primary care physicians and their malpractice insurance costs a lot more.  The equipment they use also costs a lot more.  So, surprise, surprise, their services cost more.  You, however, are willing to pay more, because your life is on the line.  Or, maybe it is your mother's or your wife's life on the line.

To the socialist who acquires life and death power over our lives, the only thing that matters is reducing costs, at least those costs on the government's books.  So, they are desperate to reduce the costs of Medicare, where most costs occur, because most people are never so likely to be desperately ill as they will be sometime after becoming 65 years old.  So, like Willie Sutton who robbed banks because that was where the money was, the socialist removes medical care for the very sick elderly to save money, because that is where the money is spent.

But, how do you do this politically without having the voters catch on?  After all, it cannot be good to be seen to pull the plug on the voter's granny or wife.  The socialist is up to the challenge.  Socialists have been dreaming about taking such power for 200 years and have done so in many countries.  They have thought about this problem.  The Wall Street Journal just did a Review & Outlook piece on this called The War on Specialists.

The Obama administration is using a regulation to shift Medicare payments from expensive specialists such as cardiologists and oncologists to primary care physicians.  The 2010 rules will reduce payments to cardiologists by 11% overall and reduce payments to oncologists by 19% overall.  They will increase payments to primary care physicians by 6 to 8%.  In general, doctors will still be paid less than market value since Medicare's price controls now pay only 0.83 times private care costs.

Echocardiogram or stress test payments will be cut by 42% and catheterization payments will be cut by 24%.  These are fundamental tools for the cardiologist.  These cuts will force many community and independent practices to shutdown, lay off staff, and make patients wait, says Jack Lewin, head of the American College of Cardiology.  These tests will be used less often as a result, so cardiologists will be making more and more guesses and uneducated guesses about heart disease problems.

The socialist administration thinks oncologists are doing too many MRIs and CT scans.  Payments for some diagnostic imaging techniques are being cut by 24%.  It used to be assumed the instruments were being used 50% of the time.  The administration is now asserting that they are used 90% of the time over a 12-hour day, or 10.8 hours.  This unrealistically high utilization rate is being used to justify reduced payments.  Similar reductions are being made in payments for the use of all expensive equipment.  Consequently, payments for anti-tumor radiation treatments are being decreased by as much as 44%. 

Max Baucus, chairman of the Senate Finance Committee, has an additional insidious way to cut costs in his "conceptual plan."  Medicare will be required to rank doctors on how much they cost the Medicare program.  Those costing the most, those in the upper 10%, will be forced to return 5% of all the payments they have received for the year.  This requirement will start in 2015.  The specialists will be the doctors in the upper 10% of costs billed to Medicare, so they will be hard hit by this requirement.  Remember, they are already being paid less than their market value, the administration's 2010 payment reductions will give them still less of market value, and then many of them will have to give 5% back.  This will function as a powerful further deterrent to specialist doctors using the full power of the tools at their disposal to diagnose and treat your disease.  The 5% of doctors being penalized each year will consist of a much larger percentage of the cardiologists and oncologists each year.  This provision is aimed directly at reducing the services of those doctors most involved in trying to save lives in deep danger.

Fewer physicians will choose to enter these specialties.  As the population of Baby Boomers greatly increases the incidence of heart disease and cancer, the specialists who treat these diseases will be reduced in number and will not be allowed or able to use the equipment that correctly diagnoses the deadly diseases and aids the cure. The expensive equipment will not be affordable given the lowered payments, so doctors will not invest in it.  No actual death panel is ever convened to consider granny's illness.  No need.  The decision has been made.  The specialists she needs and the equipment he will need if he still exists, will simply not be available.  The result:  Granny dies.  Or your wife dies.  Or your daughter dies.  Or you die.

And nobody notices.  The Cloak of Invisibility, neatly arrayed by socialist politicians and bureaucrats years before, has covered and hidden the fact that they were the death panel that pulled the highly skilled human resources and the ingenious equipment out from under granny years before.  In the process, they also halted most of the innovations that may have allowed you or your children to live longer than granny will have.  Is this really the medical care you want?

Think long and hard before you give your backing to this insidious socialist death panel lurking in the darkness.  These death dealers are bent on returning us to the Dark Ages of Medicine when magic incantations and mere guess work were offered up as medicine.  I hear that leaches are not very expensive, but we had better not tell the socialist politicians and bureaucrats about this potential cost savings.

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