Senate Democrats approved a “death panel by proxy” provision in the health care reform bill, even though one fears they may regret it. A Washington Times editorial, The haunting of Medicare clawbacks
…The provision requires that in any year in which a particular doctor’s average per-patient Medicare costs are in the top 10 percent in the nation, the federal government will force the doctor at year’s end to pay back to the government 5 percent of the Medicare fees already given to him. This provision makes no account for the results of care, its quality or even its efficiency. It just hangs a financial blunt ax over a doctor’s head, not-so-gently encouraging him to prescribe cheaper – even if less effective – care in order to avoid the penalties.
Doctors will labor knowing that far-away green-eyeshade number crunchers are doing calculations to identity from which doctors the feds will claw back fees already paid to them. Every doctor will feel at least some pressure to “race to the bottom” of allowable care in order to avoid the federal penalties. Clearly, the real losers in all this will be the Medicare patients whose care will be rationed, even unto death…
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…Democratic Sen. Kent Conrad of North Dakota, chairman of the Budget Committee, admitted that the provision is problematic and worried aloud: “As I try to put my feet in the shoes of a doctor, I don’t know how you separate out overutilization that is really overutilization. … There is no way of knowing when you go through the year, what you are going to do at the end of the year.” Mr. Conrad went on to acknowledge that the provision “really leaves me cold,” and that those who voted for it may well “regret” it when they “get down the road.” Yet he and his fellow Democrats all voted for it anyway.
More at the link.
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