American Elephants

The Federal Government Will Dictate to Doctors How They Treat Patients. by The Elephant's Child
January 1, 2014, 6:10 pm
Filed under: Politics

The Lie of the Year for 2013, was President Obama’s often repeated claim “If you like your health plan, you can keep your health plan.” So far over six million people waving their canceled plans have put the lie to that statement. In 2014, those who get their insurance through their employers will be getting their canceled plans, except for some of those who work for companies who self-insure. The president’s sales pitches are in line with those more familiar from used-car salesmen.

Obama’s claim was “You’re not going to have anybody getting in between  you and your doctor in your decision-making.” This biggest whopper of all is tucked deep inside the law.

Section 1311(h)(1)(B) of the Affordable Care Act gives the secretary of Health and Human Services, a presidential appointee, blanket authority to dictate how doctors treat patients. All patients. Not just those in government programs like Medicare and Medicaid, but also patients in private plans that they pay for themselves.

The Federal Register disclosed on December 2, that the rules are in process of being written. Starting in 2015, insurance companies will be barred from doing business with doctors who fail to comply. The rules supposedly refer to “quality” but once health care becomes a federal matter, the most important issue will be cost.

President Obama’s earliest advisers when the Affordable Care Act was written were great admirers of Britain’s National Health Service. Dr. Ezekiel Emanuel, a key adviser, early on discussed what government intervention was needed.

Dr.Emanuel said doctors take the Hippocratic Oath too seriously “as an imperative to do everything for the patient regardless of the cost or effects on others.” As long as doctors are in charge, cost control would not be possible. Betsy McCaughey spells it out:

“Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.”

Emanuel advocated top-down federal rules to allocate resources based on what he called “social justice.”

Obama’s nominee to run the Centers for Medicare and Medicaid (CMS), Dr. Donald Berwick, also insisted that the federal government must step in between doctors and their patients to curb and redistribute the use of medical resources.

Berwick said resources should be allocated based on “important subgroups.” These groups, rather than the individual patient in the doctor’s office, should be the “unit of concern,” he said. Obama’s advisers would have these considerations override your doctor’s focus on your needs.

Eighty years old and you fall and break a hip — plan on pain pills. Early on, this bunch was talking about “life years” and the usefulness of a 20 year-old who had a lifetime of valuable work years ahead of him, compared with elderly people needing kidney dialysis or expensive operations. Even Obama, in one of his rare candid moments, spoke of old people getting along on pain pills. This bunch of advisers apparently do understand that ObamaCare is going to cost, as most government programs do, far, far more than original estimates. You can’t develop a program with unlimited, but unnecessary, goodies to attract potential voters — like free contraceptives — and not understand that people will generously use, and overuse, all available benefits, and the cost of the program will skyrocket. It is inevitable.

Unfortunately the unfamiliarity on the part of the left with economics and incentives to direct the actions of free people leave them with no options but the heavy hand of government to direct efforts, and that, of course leaves them with no options but bigger and more authoritarian government. Nasty downward spiral, unnecessary deaths, a bankrupt program and more harm for the people. But “social justice” must be served, mustn’t it? What do you do with those who believe that “more control” is the answer to every problem?


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