Questions on Health Care

Here’s the last of just 25 possible questions about H.R.3200, AKA Obamacare, you can ask you Congressperson during the August recess.

Section 1131 proposes changes to the Social Security Act that pertain to payment to hospitals. It would add this language: “(1) In General.-With respect to payment for discharges from an applicable hospital…in order to account for excess readmission's in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital…”

SO, under Obamacare, will the medical decision to readmit a patient be made by a federal bureaucrat who stands between patient and doctor? Isn’t this what some have accused the insurance companies of doing?

Section 1156 is entitled: Limitations On Medicare Exceptions To The Prohibition On Certain Physician Referrals Made To Hospitals. It proposes another change to the Social Security Act. If enacted, it would require the “entity providing covered items or services for which payment may be made” to provide the government with “the names and unique physician identification numbers of all physicians with ownership or investment interest…in the entity, as well as their relatives who have ownership or interest.” Furthermore, the hospital must “disclose the fact that the hospital is partially or wholly owned by one or more physicians…on any public website for the hospital and in any public advertising for the hospital.” The fine for failing to do so is $10,000 per day for each day of non-compliance.

SO, suppose a hospital corporation has hundreds of physicians and relatives who own relatively small shares in the enterprise. Must all their names appear on a billboard that advertises the hospital? Hardly a week passes when we don’t hear about a Senator or member of the House who has a close relationship with someone who’s been the special beneficiary of that legislator’s efforts in Washington, D.C. So why is Congress proposing to apply standards to doctors that all members of Congress (some think most) obviously don’t follow themselves? Before Congress makes a house call on the docs, shouldn’t Congress clean-up its own house?

Section 1171 is entitled: Extension Of Authority Of Special Needs Plans to Restrict Enrollment. It addresses the decision-making process of including or restricting existing state “special needs” programs now under Medicaid-Medicare. They are to be analyzed for the “impact of such plans on cost, quality of care, patient satisfaction, and other subjects as specified by the Secretary.”

SO, under what conditions might Obamacare decide that it’s too expensive to continue an existing state program that serves “special needs” patients? And just exactly who is a “special needs” person?

Section 1233, Advance Care Planning Consultation, includes a subsection entitled: Expansion Of Physician Quality Reporting Initiative For End Of Life Care. It states that “For purposes of reporting data on quality measures for covered professional services…the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization [an undefined term, by the way], if appropriate…The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced planning…appropriate for eligible professionals to use to submit data to the Secretary.”

SO, basically the federal government is going to define the level of medical care I’ll receive as I lay dying by directing my physician on the range of treatment available to me under Obamacare. And, the range of that treatment will be endorsed by a “consensus-based organization” – whatever that is – and reported to the government either through my physician or an “eligible professional.” That about cover it?

[My congressman is both a physician and a conservative Republican. If he holds open meetings on Obamacare, I will go if only to observe. But, if he was a proponent of the bill, I’d first ask the question below from my own experience:]

The federal government has made a colossal mess of Medicare and Medicaid. Why should taxpayers trust it to not make a mess of America’s entire health care system?

This is the final part of this series. I hope that is has been useful and informative to you. Lee Cary has done an outstanding job of laying out questions that all of us should be asking our representatives regardless of political affiliation. As I have said many time before, if we fail to ask the questions and this fiasco passes the only person to blame will be the one staring back at you from the mirror. I urge you to make sure that your feelings on this subject are known to your representatives as well.