NRL News
Page 1
October 2009
Volume 36
Issue 10

“Death Spiral” Typifies Rationing Danger

WASHINGTON (October 15, 2009)—As congressional leaders negotiate the final versions of bills effecting the most massive health care restructuring in American history to the floors of the House and Senate for a vote (see stories, pages 10-11), the Wall Street Journal, in an October 6 editorial, warns that they are “ trying to engineer a ‘cheaper’ system so that government can afford to buy health care for all—even if the price is fewer and less innovative ways of extending and improving lives.”

The editorial highlights a “provision in the [Sen. Max] Baucus bill [reported by the Senate Finance Committee] that would punish any physician whose ‘resource use’ is considered too high. Beginning in 2015 [since amended to 2014], Medicare would rank doctors against their peers based on how much they cost the program—and then automatically cut all payments by 5% to anyone who falls into the 90th percentile or above. ... Since there will always be a missing chair when the music stops, every year one of 10 physicians will be punished if he orders too many tests, performs too many procedures, or prescribes too many drugs—whether or not the treatments result in better patient outcomes. The 5% fine is substantial given that Medicare’s price controls already pay only 83 cents on the private dollar.”

Civil libertarian columnist Nat Hentoff warned in a September 23 column entitled “Health Bill’s Deadly Fine Print,” “As the doctors struggle to keep abreast of the continually falling limit of the money they can authorize for their contingent of patients, consider what those patients will lose in the quality of their treatment.”

Because the swiftness of developments on health care legislation outpaces the gap between NRL News deadlines and the date issues of the paper reach most subscribers, readers are urged regularly to check the frequently updated blog maintained by National Right to Life’s Powell Center for Medical Ethics at http://powellcenterformedicalethics.blogspot.com/.