Monday, June 15, 2009

Top Ten Reasons Democrat Health Reform Is Bad for Patients and Doctors

With President Obama addressing the annual meeting of the American Medical Association today, we have compiled a list of why reforms proposed by the President and Democrats in Congress will harm both American patients and doctors:

  1. Government-Run Health Care.  Many Democrats—including President Obama—are insisting upon the inclusion of a so-called “public option” as part of health reform.  However, the non-partisan Lewin Group has found that a government-run plan that pays even 10 percent more than Medicare rates would result in a net 3 percent decrease in overall physician reimbursement levels—even after accounting for additional revenue from the newly ensured.
  2. More than $600 Billion in Reimbursement Cuts.  The President’s proposals this weekend for additional savings from the health care system now raise to nearly $625 billion the total amount of proposed reductions to Medicare and Medicaid spending.  While some of these proposals could result from genuine efficiency improvements, others could harm beneficiary access and care.
  3. Empowering Bureaucrats to Make Additional Reimbursement Cuts.  The President endorsed a legislative proposal allowing a board of federal bureaucrats to make “recommendations on cost reductions” over and above his proposed savings that would be binding unless Congress intervened—which could result in bureaucrats making arbitrary and harmful reductions in health care spending.
  4. Avoids Meaningful Liability Reform.  No Democrat proposals being discussed have attempted to undertake the types of meaningful liability reforms that would drive down malpractice insurance costs—and reduce defensive medical practices that result in as much as $120 billion annually in wasteful spending.
  5. Picks Winners and Losers Among Providers.  Proposals to increase reimbursement levels for primary care, or to incentivize physicians to practice in certain geographic areas and/or specialties, likely will result in net payment reductions for those physicians whose practices do not meet the federal government’s favored areas.
  6. Additional Regulation and Price Controls.  Senior Obama Administration official Sherry Glied has previously written that any large government health program funded by tax revenues will always be under-funded, and “thus raises the specter of more and more government cost containment—with government regulation eventually intruding into the private health care sector.”
  7. Patients Waiting for Care.  Particularly as Democrats have repeatedly refused to eliminate cost grounds as a factor in government reimbursement decisions, providers may be concerned by Administration official Sherry Glied’s position that waiting lines “will in some instances lead to worse health outcomes” but are acceptable because “on average” most patients won’t suffer while waiting.
  8. Harms Medical Innovation.  Multiple Democrat proposals have discussed expanding various price controls on pharmaceuticals—a one-time savings that would do nothing to slow the long-term growth in health costs, while permanently harming the research on breakthrough treatments that can cure or improve myriad diseases.
  9. Medicaid’s Low Payments and Bureaucracy.  Democrats propose significant expansions of Medicaid, which pays physicians 40 percent below private insurance plans and in most states suffers from reimbursement delays and other bureaucratic hassles.  As a plurality of individuals making between one and two times the federal poverty level have private insurance, these expansions may drive individuals away from private coverage and into a government-run plan that reimburses at significantly lower rates.
  10. Tax Increases.  President Obama’s budget proposal to limit itemized deductions for single filers with incomes over $200,000, and families with incomes over $250,000, will raise taxes for many American households—including doctors struggling with high student loan debts.