Diary

Doctors Should be Afraid, very Afraid

David Rogers of Politico, among all the recent articles on the House health care bill, has identified the key provision in the bill that will most change the world of health care:

“Section 1160 of the bill lays out an elaborate implementation scheme that empowers the Obama administration to make major changes — which Congress will have limited power to block — that could lead to a new system of reimbursements more indexed to the value of the care provided, not the traditional fee-for-service measures.”

Doctors should be terrified. They always get their payments cuts, and this provision will tie their payments to the outcomes of patients. In effect, not only will doctors see their payments cut, but they will be told how to practice medicine. If they do not prescribe the acceptable treatments, their payments will be cut even further.

And the Doctors are trading their silence on the House bill for a promise to increase their Medicare payments by $245 billion over the next ten years. But even if the doctors do get their $245 billion in new Medicare payments, if the House bill passes, those increases will be irrelevant since Section 1160 gives the Executive Branch the power to change every payment for every service, and ties it to the type of care the government thinks is the correct care. Just like the HMOs used to tie doctors payments to they type of care the HMOs thought should be given, not what the doctor thought should be done.