Senator Tom Coburn (R-OK), one of only two doctors in the Senate, has a terrific article in today’s Wall Street Journal that I highly recommend. He highlights several of the ways that the Senate bill will reduce access to health care – something that should concern all Americans.
For instance, the Reid bill (in sections 3403 and 2021) explicitly empowers Medicare to deny treatment based on cost. An Independent Medicare Advisory Board created by the bill-composed of permanent, unelected and, therefore, unaccountable members-will greatly expand the rationing practices that already occur in the program. Medicare, for example, has limited cancer patients’ access to Epogen, a costly but vital drug that stimulates red blood cell production. It has limited the use of virtual, and safer, colonoscopies due to cost concerns. And Medicare refuses medical claims at twice the rate of the largest private insurers.
Section 6301 of the Reid bill creates new comparative effectiveness research (CER) programs. CER panels have been used as rationing commissions in other countries such as the U.K., where 15,000 cancer patients die prematurely every year according to the National Cancer Intelligence Network. CER panels here could effectively dictate coverage options and ration care for plans that participate in the state insurance exchanges created by the bill.
Additionally, the Reid bill depends on the recommendations of the U.S. Preventive Services Task Force in no fewer than 14 places. This task force was responsible for advising women under 50 to not undergo annual mammograms. The administration claims the task force recommendations do not carry the force of law, but the Reid bill itself contradicts them in section 2713. The bill explicitly states, on page 17, that health insurance plans “shall provide coverage for” services approved by the task force. This chilling provision represents the government stepping between doctors and patients. When the government asserts the power to provide care, it also asserts the power to deny care.
If the bill expands Medicaid eligibility to 133% of the poverty level, that too will lead to rationing. Because Washington bureaucrats have created a system that underpays doctors, 40% of doctors already restrict access to Medicaid patients, and therefore ration care.
An expanded government health care system will mean that the government will have a say in virtually all aspects of care – recommendations on frequency of visits, reimbursement rates for providers, and for many people, actually paying the providers (through Medicare, Medicaid, and possibly a public option.) The government will have final say over who gets what, and when, if at all. At that point, we become little more than statistics in the eyes of government bureaucrats.