Home Healthcare Reform CARROTS NOW – POISON LATER


by Dustin Cortright

Establishing price controls through the Independent Medicare Payment Advisory Board(section 3403 of the law) and the Federal Coordinating Council for Comparative Effectiveness research is how the government intends to pay for the massive new subsidies and government programs.  Donald Berwick, recently appointed a head of the Center for Medicare & Medicaid said in 2009  that “the decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open.”

Attacks and misinformation by the takeover law supporters fail to address the hidden agenda and acknowledged objective to ration healthcare. Berwick has said that he is “romantic about” Britain’s National Health Service where half of the British patients wait for more than 18 weeks for care. Every year, 50,000 surgeries are canceled because patients become too sick on the waiting list to proceed.  Britain’s rationing arm is called NICE, the National Institute for Clinical Effectiveness.

The Cato Institute says, that NICE “compares various treatments and determine whether the benefits the patient receives such as prolonged life are cost-efficient.” Berwick says, “I love it”.  He wrote, “the hallmarks of proper financial management in a system are government policies, purchasing contracts, or market mechanisms that lead to a cap on total spending…”


source: aheneph.com

The takeover law gives us the Medicare Payment Advisory Board.  On 4/8/10, Peter Orszag, former White House Budget Director candidly stated that the Board “had an enormous amount of potential power….statutory power to put forth proposals that take effect automatically unless Congress votes them down.”  He says, that we needed to “move toward a system of efficiency, not quantity” and that, “it is the purpose of this Board to reduce the per capita rate of growth of medicare spending.”

Payment reductions are likely to target those areas considered to be the drivers of cost growth.  The recommendations of this Board will not go into effect until 2015.  So, rationing of care will be disguised as efficiency based medicine. Look for a lot of new “research” to come out to show popular meds, treatments, and procedures either unnecessary or harmful as the price controls take root.  Obama has said he wants to give the doctor the “incentive to do the right thing”.

Could this mean financial incentive to deny you care? Moving toward a flat fee per patient as it is in Canada and the United Kingdom pays doctors and hospitals for an entire year to care for that patient.  Instead of providing more services this system lets providers keep whatever money they do not spend.  At a local hospitals staff meeting in Nov 2009 attended by 300 physicians, an unnamed source said that the guest speaker speaking about healthcare reform told the docs, “you must change the way you think” you must “adapt or you will not survive”. Henry Aaron, a health economist at the Brookings Institute wrote, “in the 1980’s, few British chronic renal failure patients over the age of fifty were dialyzed or received transplants. British physicians told their patients and themselves that they were providing optimal treatment.”  I am hereby calling out the HHS Dir, AARP, Congressional Dems, and the journalists who ignore facts.

We are told that we will have quality care but do you want a panel of people in DC deciding what quality is in SC?  The Pres says we have to have “rules.”  The rules will be determined by the Medicare Payment Advisory Board and the Federal Coordinating Council for Effectiveness Research.   Read what physician Ed Leap, MD writes about government regulations and rules related to billing, safety, privacy, and caring for the uninsured.  …”I have simply come to believe that the government’s answers are almost always inefficient, expensive, possibly dangerous, and always inconsistent with the realities of life on the ground.”


source: khn.org


  1. Q:  Company A(US Govt): 13 Trillion in debt, increasing obligations, reckless spending record.  Company B(Current Health Carriers):  A+ claims paying ability, adequate surplus to meet unexpected claim cost.  It is just common sense that company A should assume more responsibility for how healthcare dollars are spent.  Ans: False
  2. Q: More generous health coverage benefits result in lower premiums. Ans: False
  3. Q: The average health carriers profit is 3% and many health carriers have been unable to sustain their health insurance business.  Ans: True
  4. Q: Premiums reflect the cost of healthcare and are not arbitrarily set.  Ans: True
  5. Q: Restrictions on carriers overhead expenses(“MLR”medical loss ratio requirement) leads to lower premiums.  Ans: False
  6. Q: Giving doctors a set fee per year per patient by way of a government panel is called price control and leads to rationing of care.  Ans: True
  7. Q: Giving taxpayer funded, subsidized premiums means healthcare costs have gotten lower.  Ans:  False
  8. Q: Medicare and Medicaid reimburse providers much less than private insurance.  Ans:  True
  9. Q: If docs get more patients but get less money per patient, then “efficient” care becomes the operating principle and access to care gets worse.  Ans: True
  10. Q: Rationing of care and long waits for care do in fact happen in Canada and Great Britain.  True
  11. Q: Despite Administration statements to the contrary, little to nothing in the Takeover law reduces healthcare expenditures.  True
  12. Q: Many things in the Takeover law increase the cost of insurance, reduce access to care, and limit our freedom and choices.  True
  13. Q: On page 1000, section 3403 of the Takeover Law, there are details about the independent medicare payment advisory board, aka(death panel) which the Administration and supporters say does not exist.  True
  14. Q: Congress put a rule in the Law that said no future Congress could amend or change this sacred price controlling board without repealing the entire law.  True
  15. Q: Because of price controls of this panel docs may be forced to limit care to medicare beneficiaries starting in 2015.  Thus the Medicare Payment Advisory Board rations care indirectly by limiting payments to providers.  True
  16. Q:  Most Americans would rather make healthcare decisions along with their doctor and have access to an open market of creative healthcare products where innovation, competition and accountability work.  This does not happen in the Takeover Law.  True

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