Nat Hentoff Highlights Rationing of Seniors’ Health Care in Column on Baucus Bill

Bioethics   |   Steven Ertelt   |   Sep 24, 2009   |   9:00AM   |   WASHINGTON, DC

Nat Hentoff Highlights Rationing of Seniors’ Health Care in Column on Baucus Bill

by Steven Ertelt Editor
September 24
, 2009

Washington, DC ( — Respected liberal pro-life columnist Nat Hentoff has a new opinion column he released yesterday that focuses on the concerns about rationing in the Baucus health care bill. After reading the legislative proposal, Hentoff agrees that provisions in the bill will lead to rationing of medical care for seniors.

The provisions have caused such a great last-minute problem that pro-life groups are working with two pro-life members of the Senate panel considering the bill on amendments to alleviate the concerns.

"In the Senate Finance Committee’s health-care bill, there is a dangerous provision that could deny crucial health treatments for Medicare patients," he writes in a new column posted at WorldNetDaily.

"During the continuous, extensive coverage of this proposed legislation, there has been only very limited mention – and none I’ve seen in the mainstream press – of" the provision, he writes.

The measure "penalizes doctors for Medicare patients who, for at least five years (from 2015 to 2020), authorize total treatments that wind up in the top 10 percent of national annual Medicare costs per patient."

Hentoff continues: "The 1 in 10 Medicare doctors who spend beyond this limit will themselves lose 5 percent of their own total Medicare reimbursements. Considering the already low rates Medicare doctors get – and the president pledges they will get lower – this could be a heavy penalty."

Hentoff cites the analysis form the National Right to Life Committee, specifically its medical ethics director Burke Balch.

Balch has said: "This (part of the Baucus bill) means that all doctors treating older people will constantly be driven to try to order the least-expensive tests and treatments for fear they will be caught in that top 10 percent. 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."

Hentoff notes that a section in the Baucus bill seems to be an exception to what he terms as an "iron mandate" for reducing medical-care costs that is not related to quality of care but aimed at reducing the national debt.

"There is a section (page 80, the Chairman’s Mark) that gives Kathleen Sebelius, secretary of health and human services, permission to adjust these strictures for ‘those physicians who tend to serve less healthy individuals who may require more intensive interventions,’" the pro-life columnist points out.

"But what is submerged in here is the cold fact that even if a Medicare doctor does apply this permission in treating certain patients, as he considers necessary, the pressures will continue – with regard to his entire cumulative roster of other Medicare patients – to keep very much in mind that he or she may still be in peril of winding up at the end of a year in the punishable top 10 percent of annual Medicare costs per patient," he says.

Balch says that "there will always be a top 10 percent, no matter how far down the total amount of money spent on Medicare is driven."

Hentoff agrees and says there is a real possibility that "the total annual amount of that limit will drop. So next year, doctors will try to avoid being in the penalty box for anything they authorize over $9,500."

He says Medicare doctors will not be the only losers under the Baucus bill.

"As the doctors struggle to keep abreast of the continually falling limit of the money they can authorize for their contingent of patients, consider what those patients will lose in the quality of their treatment," he writes at WorldNetDaily.

Even if the "insidious" provision is eliminated from the Baucus bill, Hentoff says " its actual existence is a further warning to all of us to pay very close attention to all the health-care ‘reform’ bills before any of them becomes law."

"For some of us, our very lives may depend on the ultimate statute – not only because of the quality of care we will get, but rather for the nature of our final exit," he concludes.

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