Baucus Health Care "Reform" Bill Pushes Doctors to OK Rationing for Seniors

Bioethics   |   Steven Ertelt   |   Sep 18, 2009   |   9:00AM   |   WASHINGTON, DC

Baucus Health Care "Reform" Bill Pushes Doctors to OK Rationing for Seniors

by Steven Ertelt Editor
September 18
, 2009

Washington, DC ( — The Baucus health care "reform" bill that is quickly becoming the potential alternative to the Kennedy bill and HR 3200 includes abortion subsidies and mandates. Additional analysis also shows the legislation includes health care rationing that would cause problems for senior citizens.

Burke J. Balch, an attorney and the director of the medical ethics center at the National Right to Life Committee, has examined the entire bill.

He points to language on pages 80-81 regarding Medicare physician payments as a concern.

"Beginning in 2015, payment would be reduced by five percent if an aggregation of the physician’s resource use is at or above the 90th percentile of national utilization," the Baucus bill says. "After five years, the Secretary would have the authority to convert the 90th percentile threshold for payment reductions to a standard measure of utilization, such as deviations from the national mean."

Balch says the language clearly makes it so doctors are pushed financially into provided less care for seniors by being urged to purchase cheaper medical tests and phase out costly treatments.

"The provision penalizing doctors establishes that for at least five years, Medicare physicians who authorize treatments for their patients that wind up in the top 10% of per capita cost for a year will lose 5% of their total Medicare reimbursements for that year," he explains to CBN News’ David Brody.

"This means that all doctors treating older people will constantly be driven to try to order the least expensive tests and treatments for fear that they will be caught in that top 10%," Balch adds.

"Note that this feature operates independently of any considerations of quality, efficiency, or waste; if you authorize enough treatment for your patients, however necessary and appropriate it may be, you are in danger of being one of the 1 in 10 doctors who will be penalized each year," Balch adds. "Moreover, it creates a moving target by definition, there will ALWAYS be a top 10%, no matter how far down the total amount of money spent on Medicare is driven."

The conclusion for the pro-life attorney is that medical care will indeed face rationing.

"The incentive this creates is purely cost-driven, without any balancing of benefit," he says to CBN News. "It will create a constant sense of uncertainty in doctors, since none can know in advance precisely what the cutoff for a given year will be resulting in still more pressure to limit treatment and diagnostic tests to the bare minimum."

David N. O’Steen, the NRLC executive director, previously communicated with about the rationing components.

"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."

Related web sites:
National Right to Life –

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