Common Sense Political Thought

Sharon asked a simple question:

Why Don’t Democrats Just Admit…

The Baucus “bill” explodes the deficit, creates even more disincentives for doctors to treat Medicaire patients and RAISES BLOODY COSTS FOR EVERYONE???

To be honest, I am so tired of the lying going on with the so-called health care debate. Read this and remember the 14 despicable jerks who passed this monstrosity out of committee.

And her simple question has a simple answer: if the proponents told the truth about the costs, it would never pass.

The Hot Air story Sharon referenced goes over how the projected costs soar during the second decade, and notes the disingenuous way in which the first decade is priced out: since the bill wouldn’t actually be implemented for a couple of years, two zero-cost years are included in the first decade, making it seem like the real costs are lower. Ed Morrissey quoted Jeffrey Anderson, a senior fellow in health-care studies at the Pacific Research Institute, in The New York Post:

As the CBO notes, his bill would cut Medicare payments to doctors by 25 percent in 2011, then hold them at that level perpetually. In other words, given inflation, Baucus proposes endless cuts in what the program pays physicians and others.

Thing is, physicians are already reluctant to take Medicare patients, because Medicare payments are already too low.

Note this, from the Department of Health and Human Services:

CMS PROPOSES PAYMENT, POLICY CHANGES FOR PHYSICIANS SERVICES TO MEDICARE BENEFICIARIES IN 2010

The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals, and other settings.

CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.

The Medicare law requires CMS to adjust the MPFS payment rates annually based on an update formula which includes application of the Sustainable Growth Rate or SGR that was adopted in the Balanced Budget Act of 1997. This formula has yielded negative updates every year beginning in CY 2002, although CMS was able to take administrative steps to avert a reduction in CY 2003, and Congress has taken a series of legislative actions to prevent reductions in CYs 2004-2009. Based on current data, CMS is projecting a rate reduction of -21.5 percent for CY 2010.

As part of health care reform, the Administration supports comprehensive, but fiscally responsible, reforms to the physician payment formula. Consistent with this goal, the Administration announced in the FY 2010 President’s Budget that it would explore the breadth of options available under current authority to facilitate such reforms, including an assessment of whether the cost of physician-administered drugs should continue to be included in the payment formula. Thus, while working with Congress to develop a more appropriate mechanism for updating physician payment rates, CMS is proposing to remove physician-administered drugs from the definition of “physician services” for purposes of computing the physician update formula in anticipation of enactment of legislation to provide fundamental reforms to Medicare physician payments. While the proposal will not change the projected update for services during CY 2010, CMS projects that it would reduce the number of years in which physicians are projected to experience a negative update.

CMS is also proposing to stop making payment for consultation codes, which are typically billed by specialists and are paid at a higher rate than equivalent evaluation and management (E/M) services. Practitioners will use existing E/M service codes when providing these services instead. Resulting savings would be redistributed to increase payments for the existing E/M services.

Emphasis mine. Private insurance payers pay roughly 30% more than does Medicare, and, according to the American Medical Associations 2008 insurer study, Medicare denies a higher percentage (6.85%) of claims than do private insurers.

Of course, I documented earlier the fact that Medicare doesn’t pay its own way when it comes to hospital reimbursements, and now you can see that the government doesn’t pay its own way when it comes to paying physicians. If whatever health care passes the Congress keeps trying to save money by reducing payments to physicians, physicians will do the logical thing — the thing that many of them do now concerning Medicaid patients — and simply not accept them as patients. If we somehow force physicians to accept public-pay patients, we’ll eventually run into the same situation as our Canadian brethren: a shortage of medical personnel period, because they can’t make enough money.

It’s really pretty simple: the Democrats may have the political will and muscle to push some sort of health care “reform” bill through, but they are lying about the costs, and, deep down, they know they are lying about the costs. Perhaps they think that it’s just so important that knowingly lying about the costs is a price they are willing to pay to get it passed. But if it does pass, working men and women in this country will be poorer for it.