Penalizing Those Who Serve The Most Vulnerable

The Baucus/Obama health care bill will financially penalize physicians who provide care for the sickest patients. A provision in the bill punishes doctors whose treatment plans put them in the top 10% of national annual Medicare costs per patient.

This 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.

This will pressure doctors to avoid taking responsibility for the oldest and sickest (i.e., most vulnerable) patients. And every year, the pressure could intensify as a brutal cycle is set in motion:

There will always be top a 10 percent, no matter how far down the total amount of money spent on Medicare is driven. Say that in 2015, the top 10 percent is anything over $10,000 per patient. In 2016, most doctors will scramble to hold down the treatments they authorize to avoid breaking that limit.

But the real possibility, as a result, is 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.

As tough as this will be for physicians, patients will be the real losers.

As the doctors struggle with 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.

This is what happens when politicians design health care systems.

h/t: Green Room

First Amendment Trampled by Federal Government

The Democrat-run Federal Government has ordered a private insurance company to stop educating seniors on the potential disadvantages of ObamaCare proposals.

The Health and Human Services Department (HHS), which oversees the Centers for Medicare & Medicaid Services (CMS), launched an investigation of Humana after getting a complaint from His Royal Highness, Max Baucus, D-MT.

Background info from the AP:

Humana is one of the largest private carriers serving seniors under a program called Medicare Advantage. About one-fourth of the elderly and disabled people covered under Medicare participate in the Advantage program, which offers a choice of private plans that usually deliver added benefits.

Humana has about 1.4 million Medicare Advantage enrollees, and the program accounts for about half the company's revenue...

Humana sent out a mailer focused specifically on the Medicare Advantage program. Here are some excerpts from the letter that was banned by your Imperial Federal Government:

With the media reporting daily on Congress' and President Obama's efforts to enact meaningful health reforms this year, many Humana Medicare Advantage (MA) members are contacting us with questions. Members just like you want to know what these reforms might mean for their Medicare health plan and how they can get involved to help protect Medicare Advantage.

***

Let your Members of Congress know why Medicare Advantage is important to you. Congress is considering significant cuts to Medicare Advantage now, and your Members of Congress will want to know why this program is valuable to you because these cuts could mean higher costs and benefit reductions to many on Medicare Advantage.

***

Leading health reform proposals being considered in Washington, D.C., this summer include billions in Medicare Advantage funding cuts, as well as spending reductions to original Medicare and Medicaid. While these programs need to be made more efficient, if the proposed funding cut levels become law, millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable.

As the Wall Street Journal has noted, senior citizens enrolled in Medicare Advantage have good reason to be concerned about the Obama-Baucus plan:

"The Baucus draft legislation slashes $123 billion over the next decade from Medicare Advantage, which Democrats hate despite the fact that almost one-fourth of beneficiaries have chosen it over traditional fee-for-service Medicare. One reason seniors like it is because private insurers focus on quality and preventive care and try to manage benefits, as opposed to simply paying bills."

This is obviously not the sort of information that should be freely disseminated. Fortunately, our benevolent dictators in Washington D.C. have banned the Humana letter in order to protect senior citizens from the vulgar and unvarnished truth. Here are some excerpts from the letter sent to Humana from our courageous HHS/CMS Officials:

CMS has learned that Humana has been contacting enrollees in one or more of its plans and alleging that current health care reform legislation affecting Medicare could hurt “millions of seniors and disabled individuals..."

***

CMS is concerned that, among other things, this information is misleading and confusing to beneficiaries, represents information to beneficiaries as official communications about the Medicare Advantage program, and is potentially contrary to federal regulations...

***

As we continue our research into this issue, we are instructing you to end immediately all such mailings to beneficiaries and to remove any related materials directed to Medicare enrollees from your website.

Please be advised that we take this matter very seriously and, based upon the findings of our investigation, will pursue compliance and enforcement actions. [emphasis mine]

Chilling.

Yesterday, the agency also barred all Advantage insurers from providing similar information to their beneficiaries.

David Henderson makes an important observation: "One of the ways that governments try to 'win' debates is to make debate by the other side illegal. This is what HHS is doing, at the behest of Senator Baucus."

Baucus and his statist buddies should keep their fingers crossed. If in spite of the Humana letter ban, Seniors do learn too much and begin to feel threatened by what Democrats are trying to do with Medicare Advantage, it could have a significant impact on the 2010 elections. Karl Rove explains:

"There are roughly 23,400 seniors on average in a congressional district who have Medicare Advantage, but who face losing it if Mr. Obama has his way. That's enough votes to tip most competitive House and Senate races."

Update:

Sen. Mitch McConnell: Obama is stifling dissent on health care reform, h/t Adrienne