Redefining, Reducing and Rationing Health Care

Peter Singer, in his op-ed for the New York Times this weekend, seems to be unaware of the difference that our mobility in the United States - both in geography and society - can make. We have choices, can call on friends and family and/or gain sympathy of the wider community (as demonstrated by the pink ribbons on so many cars and products) to obtain what we need and sometimes what we want. (Hear those Rolling Stones in the background? )

I don't expect perfect this year, but I'd sure like to have more options than Pelosi, Rangel, Waxman and Kennedy seem to allow. And, like many other Americans, I'd be more reassured if the Speaker and the House Ways and Means Committee would agree to sign up for the "public option" and if Ted Kennedy would accept the same rationing he's proposing for the rest of us. (No Chappaquiddick health care jokes, please - but isn't he aware that he's going to need readmission to the hospital soon? And don't you think the anecdotes he tells are ironic?)

Or, if the President could get his budget report out on time.

However, the AMA has endorsed the House Bill (no number, yet) as unveiled last week, in spite of the fact that the definition of "primary care provider" includes nurse practitioners. The White House immediately began pushing for cuts in physician payments to ensure that there's no deficit. Orszag hinted on TV yesterday that the 20% cut due next year would work just fine.

My letter to the Board of Trustees of the AMA resulted in a reply from Dr. Rohack:
"As noted, there are elements in the bill that will help you as a family physician in Texas. And as fellow Texan {sic}, you know as well as I that leading the nation in the number of uninsured patients is not a proud statistic and having some federal help will be needed for our patients since our Texas legislature continues to pass on opportunities to help them."

(And Texas' economy is relatively stable as our State government is solvent, too, Dr. Rohack.)

I'm not sure how many of you remember the retroactive tax increases passed by Congress and even instituted by IRS rules. But I'm sure that you remember this Congress' threat this year to retroactively tax the bonuses given to AIG employees.

The House "Reform" Bill allows the Secretary of Health and Human Services not only to set what we are paid, but to set the Nation's mandated insurance coverage, premium rates and then the taxes and penalties that are supposed to pay for half the cost of the Bill, all coordinated with the IRS.

The other half will come from proposed savings. That 20% cut in Physician payments from Medicare is going to look awfully attractive to the bureaucrats.

Everyone's income is no safer than the payment your Family Nurse, uh, Doctor may receive under this Bill.