Diary

Rationing Under Medicare - Right Now

Here’s some information that is instructive about what life would be like under the proposed health care insurance public option and that tells us why, when people crow about Medicare being a government program that everyone loves, there should be an informed response that educates those who are and will be patients under it (i.e., virtually all of us):

From the August 28, 2009, report from the President of the Florida Medical Association, James B. Dolan, MD:

“…I want to share with you a disturbing development emanating from the Centers for Medicaid & Medicare Services (CMS) in Washington.  Hiding behind the zero-sum, budget neutrality idiocy of the SGR [Medicare Sustainable Growth Rate*], CMS has promulgated a change in the Medicare fee schedule. This change cuts reimbursement for certain cardiac diagnostic testing by up to 40 percent, and CMS is establishing similar cuts in reimbursement for certain end-stage oncology drugs and radiation oncology treatments.  In my conversations with cardiologists, their opinion is uniform that it will essentially put them out of business.  My sister is an oncologist and has shared with me that she will be made the villain, having to tell her patients that although she could prolong their life, Medicare will not pay for the drugs and, thus, has effectively hastened the time of their death.

“Application of the budget neutrality concept is flawed and must be changed.  The application of this regressive principle means that factors such as the nation’s aging population and new technologies cannot be included in the Medicare budget.  As new patient needs arise and advanced technologies become available, the Medicare budget should adjust to account for these changes.  …

“This is simply wrong.  Rather than encourage clinical protocols and guidelines, CMS, once again hiding behind the skirts of the SGR, uses the bludgeon of the Medicare fee schedule to effectively force rationing on our patients.  Make no mistake; my specialty of orthopaedic surgery may be next.  Consider this: If CMS doesn’t like an X-ray, MRI or bone density imaging in my office, it can just quit paying for the service.”

*from John Cogan’s ‘Regulating Health Insurance’ blog

Fla Mom

P.S.–How do you adjust fonts?  Thanks-