Published August 24, 2011
If you have been watching the unraveling of our economy over the past several weeks, then what is coming very soon to health care should really get your attention. The financial world has reacted negatively and punished us for the misguided policies of President Obama and his economic team.
Simply substitute Treasury Secretary Timothy Geitner with HHS Secretary Kathleen Sebelius, former White House budget direct Peter Orszag with CMS director Donald Berwick, and economic advisor Larry Summers with health care adviser Nancy Ann Deparle, and you get an idea of the types of individuals and the level of competence of those who are now at the helm of the health care system.
The names are different but the ideology is the same -- government can run things better than the private sector. The big difference is that the outcome of government run health care will be more than a blow to the pocketbook. This is life and death.
The result of the Obama economic policies will seem trivial compared to debacle coming in health care. Failure to recognize parallels between the way this administration has handled finance and health care will have dire consequences.
Critics of ObamaCare, like the critics of the economy, have been maligned by the Democrats and the mainstream media.
Congressman Paul Ryan has clearly explained how the Medicare ponzi scheme is unsustainable. He was out in front of this issue with a plan that would actually preserve Medicare, but instead has been demagogued with accusations of throwing granny "off the cliff".
In fact, it is the president's policies that are propelling that wheelchair. Medicare as we know it was destroyed the day that Obama signed the Affordable Care Act (ACA) into law. Only in the world of Obamanomics and Secretary Sebelius double counting, can pulling out a half trillion dollars from Medicare produce anything other than cuts to a system that is already broke. The only solution is rationing of care to seniors -- something that Donald Berwick has publicly recognized as necessary as long as we do it with our "eyes open", yet repeatedly has denied is going to happen.
“Stealth” rationing of care to Medicare patients is imminent. This means less availability of doctors for Medicare patients because physicians will limit or stop seeing seniors. They just won’t be able to afford to see them any longer. The reason- cuts to physician reimbursement from four different places- the direct cuts to Medicare in the ACA, the bill due on the “doc fix”, the impending cuts at the hand of the Independent Payment Advisory Board (IPAB), and the latest cuts as a result of the new Congressional super committee.
On January 1, 2012, the sustainable growth rate for Medicare (SGR or "doc fix”) comes up again, having been postponed 5 times in 2011. Doctor reimbursement is set to be slashed by 30%, unless Congress shelves this ill-conceived portion or the 1997 Balanced Budget Act (ironic that we are focused on this part of the act, instead of balancing the budget). This will cost $300 Billion dollars- money that was conveniently not figured in the cost of ObamaCare.
The IPAB is a 15 person, unelected board, within the executive branch which is charged with cutting Medicare reimbursements if spending exceeds projections. Their decisions are not subject to Congressional oversight, and are exempt from judicial review. And hospitals are not subject to their cuts until 2020, which means that all cuts will be at the expense of physicians, and hence patients.
The financial crisis and the debt ceiling compromise has produced yet another bad idea -- the Congressional super committee, charged with having to come up with an additional $1.5 Trillion in spending cuts. If they fail to reach an agreement, there will be automatic cuts to defense and social programs such as Medicare, through a process called “sequestration”. These Medicare cuts affect not only physicians, but also hospitals. Again, fewer seniors will receive care because of this.
The 11th Circuit Court of Appeals ruling last week on the unconstitutionality of the mandate to purchase health insurance has all but assured that this case will be heard by the Supreme Court. Hopefully, they will undo what should have never been, and help to ensure that people who are counting on a certain level of health care will actually receive it.
Dr. Hal Scherz is the founder and president of Docs4PatientCare.