Speaker Pelosi’s Health Care Takeover: Bad for Patients and Doctors
The Republican Conference has compiled a list of provisions in the Pelosi health care bill that would harm American patients and doctors:
Government-Run Health Care. Many Democrats—including President Obama—are insisting upon the inclusion of a so-called “public option” as part of a health care bill. However, H.R. 3962 would promote “choice” by enrolling all Medicare-participating physicians in the government-run plan unless they opt out. The bill also gives the HHS Secretary the power force physicians not to accept patients with private insurance as a “condition of participation” in the government-run plan. In addition, the non-partisan Lewin Group has found that the government-run plan in H.R. 3962 would result in up to 114 million individuals losing their current insurance.
Pay Cut for America’s Physicians: The Lewin Group also found that the bill provisions—which do not prohibit the government from utilizing Medicare payment rates that are 20 percent below private payment levels—could result in a net decrease in physician reimbursement levels of $16,207 annually—even after accounting for additional revenue from the newly insured.
Avoids and Repeals Meaningful Liability Reform. While Section 2531 of the bill provides “incentive payments” to States with alternative medical liability laws, it conditions States’ receipt of such funding on passing a law that “does not limit attorneys’ fees or impose caps on damages”—protecting trial lawyers’ paychecks, while doing little to stem defensive medical practices that result in as much as $120 billion annually in wasteful spending.
Opens the Door to Government Rationing. Democrats have repeatedly refused to eliminate cost grounds as a factor in coverage decisions, and H.R. 3962 includes no limitations on making reimbursement decisions on cost grounds. Therefore, patients may be concerned that the bill could lead to the denial of life-saving treatments, particularly given senior 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.
Harms Medical Innovation. H.R. 3962 includes several provisions imposing price controls within the health care industry. These one-time savings 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.
Medicaid’s Low Payments and Bureaucracy. H.R. 3962 includes 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. While the bill includes provisions purportedly increasing Medicaid reimbursement levels for primary care, Members may note that in Massachusetts, reimbursement increases promised under its 2006 health reform law were among the first items placed on the budgetary chopping block—and the resulting financial difficulties have forced providers to file suit against the Commonwealth as a result. Moreover, as a plurality of individuals making between one and two times the federal poverty level have private insurance, the bill’s expansion of Medicaid to individuals with incomes of up to 150 percent of the poverty level may drive individuals away from private coverage and into a government-run plan that reimburses at significantly lower rates.
Tax Increases. The provisions in H.R. 3962 imposing nearly half a trillion dollars of “surtaxes” on “high-income” filers would raise taxes for many American households—including doctors operating small practices, who may report income in excess of the “surtax” threshold limits, even though their net personal income could be sharply below those levels. Given a potential net cut in overall physician reimbursements, a tax increase on physicians would represent a “double whammy” that could compel small practices to lay off workers.