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MEDICARE WILL ANSWER TO NO ONE.
Medicare is well on its way to reduce Medicare spending. They will target doctors and be free from congressional intrusion. They'll have the power to decide when a cheaper medical option will suffice for a given problem. Congressional authority will be absent unless they pass a separate law to explicitly block Medicare's newly acquired powers. Medicare actions will not be subject to judicial reviews.
Doctors will be forced to join large groups, and solo practitioners will become extinct. Medical innovation will stop and cheap medical devices will be the norm. There will be no regular improvements in annual upgrades of medical devices.
HOW TO CONTROL COSTS
The best way for Obama care to restrain medical costs is through controlling medical specialists. The first game to control costs will be to control surgeons and medical devices that they use, because that's where the bulk of spending is. They often make wasteful treatment decisions. Drs. will find financial penalties and regulations constrain their costly clinical options.
MEDICARE’S NEW OMNIPOTENT POWERS
The Senate gave to the centers for Medicare and Medicaid services, a new independent Medicare advisory board. It will be made up of experts assigned to find new ways to reduce Medicare spending as well as private sector health spending. This will target doctors for spending cuts and will also be free from congressional intrusion (It would begin work by 2014).
This agency (an authority all to itself) will rule on when medical devices and drugs can be used and how they should be priced. They will have the power to decide when a cheaper medical option will suffice for a given problem. Medicare will only then have to pay for the least costly alternative.
BY- PASSING THE JUSTICE SYSTEM
On December 22, the US Court of Appeals denied the Justice Department appeal. This same administrative power will be given in this Senate bill, making the court decision meaningless. Hayes versus Sibelius involved a patient who was denied a prescription treatment for lung disease by Medicare. Medicare decided to pay for a different drug that would be suitable for a cheaper alternative.
Obama will try to attain into law the powers that he could not get through the court system. This bill lets Medicare see any restrictive payment authority it wants from a Medicare commission, which is established for the purpose to control costs. If Medicare overreaches this boundary, Congress will be required to pass a separate law to explicitly block Medicare's newly acquired powers. This bill is designed to prevent congresses from acting in a timely fashion.
Medicare's actions will not be subject to judicial review. This takes away the rights of patients to sue the government. Today's Medicare coverage laws allow you the patient to feel any of the decisions of the new Medicare commission. Private. health insurers however will still be required to comply with the patience appeal rights under the Senate bill. The government has exempted itself from the same sort of protections.
STOP CADILLAC MEDICAL TREATMENTS
Medicare will have the power to control which medical devices the surgeon uses. By clamping down on expensive procedures the agencies will have authority over the specialists themselves. In the past it was hard for a central bureaucracy to control individual physicians. Obama care will fix this by putting the doctors on the financials for their treatment decisions. Long-Shoremen Union "Cadillac heath plan" will retain its exemption.
GENERAL PRACTITIONERS SQUEEZED
General practitioners who refer patients to specialists will also face financial penalties under this plan. They will be cut 5% of their Medicare pay when they have a brigade is use of resources above the 90 percentile of national utilization., (section 3003 Chairman's Mark). Doctors will quit referring patients to costly specialists like surgeons, since these penalties will put the recurring general practitioner on the hook for the cost of the referral and perhaps any resulting procedures.
JOIN A BIG GROUP OR QUIT DOCTOR
Doctors who have a financial incentive to consolidate their practices. In this way Medicare will easily apply its regulations to institutions and manage big groups of doctors rather than individual doctors.
If a doctor wants to remain in solo practice, his overhead requirements will become increasingly absorbed during the such as requiring three years of medical records every time a doctor's orders routine medical equipment like wheelchairs. This should be the death of rural solo doctors.
Doctors will be forced to give up their small practices and go into larger medical groups, or become salaried by hospitals. Doctors will share with the government any savings that the government achieves by delivering less care ( section 3022). This will only occur if the doctors are part of groups caring for more than 5000 Medicare patients and have in place some leadership and management structures, including clinical and administrative systems.
MEDICARE NOW ABOVE CONGRESSIONAL AUTHORITY
Medicare is given for the first time broad authority to roll these programs out nationally without needing to go back to Congress for more authority.
MEDICAL ADVANCES WILL BE CURTAILED
Regulating medicines has always been a local endeavor, with medical journals and professional medical societies setting clinical standards. This made sense. Medical practice evolves more quickly than even the latest technologies that doctors use. Especially in surgery, were advances come from experimentation by good doctors to try different kinds of surgical approaches.
CHEAP MEDICAL DEVICES WILL BE THE NORM
By regulating medical devices and pricing, innovation will be discouraged. Improvements in medical devices come with each generation of the device showing clinical relevance advances over previous models. This is because the underlying hardware that turns on embedded software and micro processors are constantly upgraded. Now with Medicare pricing similar devices off one another, a reference point on pricing schemes will be used as in Europe. Manufacturers will hold back from making small changes. They will only introduce new models every four or five years sufficient enough and unique enough to fall outside of the Medicare pricing schemes. Meanwhile you will have lost the benefit of regular improvements and annual upgrades that now characterize medical devices.
Private . insurance companies will follow the pricing from Medicare, since they will both be managed from the same bureaucracy. The standard for medical care will be set by Medicare. You won't have to change your doctor. But it's clear that doctors will be forced to change how they make their medical decisions involving your illnesses.
COMMENTARY
The standard for medical care will be set by Medicare. Doctors will be forced to change how they make their medical decisions involving your illness based on financial concerns.
Doctors will be graded on their performance by the amount of money they cost Medicare. There will be no experimentation by good doctors to try different surgical approaches. Medical journalism and professional medical societies will longer set clinical standards. Rural America will lose all of its solo family doctors. A doctor will first become a businessman and then a healer.
In short, traditional medicine will disappear and national healthcare will appear.
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Visit www.drneedles.com for more commentaries on controversial medical subjects. Your comments are always appreciated.
RELATED POSTS: HEALTH BILL WINNERS AND LOSERS (1)
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Visit www.drneedles.com for more commentaries on controversial medical subjects. Your comments are always appreciated.
Source WSJ 12.24.09
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