Curmudgeon's Corner

Devilish Details...

Posted by Al Campbell on Oct. 5, 2009

Economy, Healthcare, Political, Quality of Life, Taxes, U.S.

The Senate Finance Committee finished its work at 2AM on Friday morning and sent the package off to the Congressional Budget Office for their work to estimate the costs involved.  All is well...or is it?

Some of those devilish details have begun to surface and they are problematic for most of us.  Let's begin with Medicare:

There is a provision referred to as a "clawback" provision that was approved by straight party vote of Democrats 13 to 10.  It requires that doctors who are found to have been in the upper 10% of doctors in the country so far as Medicare reimbursement are to be required to pay back 5% of what they were paid in then whole year.

What are some of the predictable outcomes?

Doctors will not have any way to determine where they stand until it is too late.  Those with predominately Medicare clientèle will have to begin to limit their appointments as early as the middle of the year if they think they may be in danger of the clawback provision.  Or, they can simply not schedule follow-up visits where they'd have made certain the treatments prescribed earlier were accomplishing the goal.  Or, they'll curtail the total number of Medicare patients they see in a given year.  Or, they'll take time off near the end of the year.

Doctors who practice in Florida and Arizona and parts of Texas and Alabama will be highly susceptible to the clawback provisions because of the "snowbird" senior migration to those states during the winter months.  Many of those doctors provide elective non-covered services, so they may simply curtail their Medicare practices for whatever time frame they think they might need, and divert their time to other fee paid services.

You can be assured that as soon as a few doctors are hit, the news and the numbers will be circulated so that all doctors will know what they need to do to avoid a similar fate.

All in all, this bodes ill for seniors, and the rest of Americans, and is a direct function of the phenomenon that we have come to understand is always present in government-funded health care programs -

There is never enough money to cover everything when health care is "free", so some people go without as the result. 

The Committee voted down an amendment to ban the use of government money for abortions which is the equivalent of approving abortions using federal funds,  If it isn't specifically excluded, it is included.

Similarly, the attempt to specifically exclude coverage for illegal aliens was defeated thus making us more of a magnet for illegals who need health care.

There is some tough stuff coming at us in the coming weeks.  If the health care, or health insurance, reform hasn't been passed in the next ten to twelve weeks, it will likely be dead since no one wants to vote for this and then immediately begin campaigning for re-election.

As if this isn't enough, there is a cap and tax bill due to be voted upon, as well.

We lose if either is approved.

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The Curmudgeon Blog today is titled "Afghanistan: Iraq or Viet Nam?".