Baucus Bill Pressures Doctors to Ration Health Care Via Financial Incentives

Bioethics   |   Steven Ertelt   |   Sep 16, 2009   |   9:00AM   |   WASHINGTON, DC

Baucus Bill Pressures Doctors to Ration Health Care Via Financial Incentives

by Steven Ertelt Editor
September 16
, 2009

Washington, DC ( — The initial analysis of the new Baucus health care bill in the Senate finds the measure includes massive abortion subsidies and mandates. However, an analysis from the National Right to Life Committee also reveals the bill contains health care rationing components.

David N. O’Steen, the NRLC executive director, tells that the measure has incentives for doctors to provide less medical care and penalizes physicians who don’t.

"With respect to rationing, the proposal contains a Medicare provision that, beginning in 2015, would severely financially penalize physicians who are in the top 10% of medical resource use," he explained.

"This provision does not link funding to outcomes or quality; instead, it will force a ‘race to the bottom’ with relentless pressure on doctors to limit health care for their older patients," O’Steen adds. "On top of the significant Medicare cuts in the bill, this will gravely endanger the lives of America’s senior citizens."

Right to Life is also concerned about a comparative effectiveness provision.

In the Kennedy health care plan that has already been approved by another Senate committee, a measure is employed that calls for a system similar to the “quality of life years” system, or QALY, in England where payment for treatment is only authorized if it extends the quality of life not the length of life.

Under such a system someone in a wheelchair is determined to have a lower quality of life compared with an able-bodied person.

National Right to Life asked lawmakers to support the Enzi amendment, which would have said the government can’t use that system to deny treatment to people on the basis of a disability or degree of medical dependency or quality of life, but the HELP committee defeated it.

O’Steen says the Baucus bill "does contain language to prevent the use of comparative effectiveness analysis in a manner that would discriminatorily deny treatment because of age, disability, or terminal illness.

"However, this language would not affect the financial incentive to ration care" as he earlier described.

There are other places in the bill where the Secretary of Health and Human Services is given discretion to regulate the treatment that healthcare providers can give to their patients and O’Steen says NRLC will continue to review the bill and provide further analysis.

Related web sites:
National Right to Life –

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