The Worst Bill Ever

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http://spectator.org/archives/2009/11/11/the-absolutely-worst-bill-ever

Right Prescription

The Absolutely Worst Bill Ever

By Peter Ferrara on 11.11.09 @ 6:08AM

"The Worst Bill Ever." That is the title the always calm and rational Wall Street Journal put on its editorial on November 1 about the government health care takeover bill that passed the House last week on virtually a party line vote, 220-215. But even this label doesn't fully communicate the outright assault on the American people involved in this legislation. The bill is a serious threat not only to your freedom and prosperity, but to your very life as well.

That is because at the heart of this bill is a cruel perversion. The bill labors mightily (though it actually fails) to expand insurance coverage to everyone (taking the most expensive route possible). But then it is devoted to taking away the very health care that you may need to save your life, or the life of a loved one.

Pelosi's Death Panels

The bill would create 118 new federal boards, bureaucracies, commissions, and programs, which as a group have the power to ration and deny you health care. These are the Pelosi death panels. They include the Health Choices Administration, the Health Benefits Advisory Committee, the Health Insurance Exchange, the Public Health Insurance Option, the Center for Comparative Effectiveness Research, the Comparative Effectiveness Research Commission, the Accountable Care Organization Pilot Program, the Community Based Medical Home Pilot Program, the Independent Patient Centered Medical Home Pilot Program, and many others.

One of the ways that health rationing would be carried out is through so-called "Comparative Effectiveness," where national health care bureaucracies will decide what health care treatments, procedures, therapies and drugs work best, and which don't. You would think that is what your doctor is for, using his medical knowledge and direct personal observation of your condition and health history to prescribe what is best for you. But liberal Democrats insist that faraway federal bureaucrats who don't know anything about you will know exactly what health care will work best, in all cases. The House bill says that the decisions of federal bureaucrats on comparative effectiveness "will be delivered to doctors electronically to guide their use of medical items and services," as Betsy McCaughey reports in the Wall Street Journal on November 7. If doctors don't take the hint, and use their own judgment as to your care instead, they will be penalized in their compensation under Pay for Performance.

That policy was explained in a June report from President Obama's Council of Economic Advisors (CEA), entitled "The Economic Case for Health Care Reform." That report says that 30% of health care in America is waste, and wise government bureaucrats are going to identify exactly whose health care is waste and cut it out. Another policy for accomplishing this is called "Cost Effectiveness," where wise government bureaucrats will decide whether your health care is worth the cost to society. The House health bill creates the bureaucracies with the power and authority to carry out these policies.

[bonnie]

But it is far worse even than this. Through the Public Option, the Medicare cuts discussed below, and new rules and regulations imposed on compensation for doctors, hospitals, and other health providers more generally, the resources that sustain our highly advanced, sophisticated, cutting edge, high tech medical system will be sharply constricted. The incentives for investment in new innovations, advanced medical equipment, new miracle cure drugs, and first-rate hospital and clinic facilities will be decimated. Just when the rapid advancement of science and technology is opening up new vistas to counter disease, suffering, and death, self-congratulatory politicians and bureaucrats are stomping in and shutting it down.

In the future, when you or a loved one is struck with cancer, or heart disease, or your premature baby is struggling for life, the surgery, the machine, the pill that could have saved a life, will not be there. When the doctors come to tell you that there is nothing they can do, they are not going to explain whether that is due to medical science, or to politics and bureaucracy, and you will not know. But more and more likely over time, you will be a victim of the declining American standard of living imposed by ideological extremists, as reflected in part in the loss of the best health care possible.

Exactly to the contrary, our public policy should be focused on maximizing the advancement of health care in this new age of modern science by removing government burdens and barriers. We do need to control costs, but by introducing market incentives for patients, doctors and hospitals, so they can be in charge and make appropriate decisions, free of financially interested third party bureaucracies. It's called Patient Power, the true alternative to what Washington is doing now. Jim Pinkerton has been brilliantly making this case for months now on his Serious Medicine Strategy blog, though the argument goes all the way back to John Goodman's book, Patient Power.

But the left-wing extremists currently in complete control of Washington have no understanding of any of this. They are wedded, emotionally and religiously, to outdated ideological crusades of 100 years ago. This is a time of great challenge for the American people, like World War II, the Civil War, or the Revolutionary War. If you are not involved in the solution, then you are not only letting down America, but your family, and yourself.

Medicare Cuts

One confusion arising from the House bill is that its provisions are phased in over several years. Over the first 10 years of full operation, the House bill actually cuts Medicare by $800 billion, as scored by CBO. The cuts for Medicare Advantage plans will be close to $200 billion, and despite President Obama's phony shtick that if you like your health plan you can keep it, the Administration itself estimates that 8 million seniors will lose their Medicare Advantage plan as a result, 73% of those with such plans.

This is the beginning of health care rationing for seniors, as the payments to their doctors and hospitals for the care that currently maintains their health will be slashed back. In addition, as Betsy McCaughey explains in the Journal, the House bill

moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home." The medical home is this decade's version of HMO restrictions on care. A primary care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary care provider. Medical homes begin with demonstration projects, but… HHS…is authorized to "disseminate this approach rapidly on a national basis."

What this means is that your doctor is paid a flat monthly fee for your care, and referring you to a specialist or for a diagnostic test effectively comes out of his pocket. So if you need an MRI or a CT scan to see if you have cancer, or to check if that pain in your chest is due to clogged arteries, or if you need to see a specialist to treat cancer or heart disease, the doctor has a financial interest to delay or deny it. Financially, if you are actually this sick, he will be better off if you die sooner rather than later. That is the result of the perverted, inverse incentives the House health bill creates for medical providers.

[Woody]

Yes. This is a bad Bill. But I don't think it is the worst Bill. Clinton was the worst Bill.