If you would like a pre-Obama Care window into the possible future of American Health Care–if Democrats in Congress are successful in passing their sweeping health care legislation, you need look no further than government imposed rationing of heart disease prevention in this country. It is a travesty in the making and should demonstrate to everyone the capricious nature of government control over our health care.
I am writing of the Obama Administration’s – regulatory decision – to go ahead with a massive cut in Medicare payments to cardiologists. I emphasize that this is a regulatory decision because it was not made by the Congress legislatively (not that that would be ok) but, instead, it was made by the massive Health and Human Services Department of the US Government. Given the limited resources of the Medicare budget, in order to increase payments to general practitioners (in an effort to attract more such doctors – a good idea), bureaucrats needed to gore somebody’s ox and cardiologists were chosen (a horrible idea).
The decision to do so is astonishing.
Keep in mind that the very purpose of health care is to improve the health and therefore the lives of Americans. The cardiologist community has been wildly successful in that endeavor. Although heart disease remains the #1 killer of Americans, the mortality rate for heart attacks has plummeted. For instance, the post-heart attack, 30-day mortality rate decreased from 18.9 percent in 1995 to 16.1 percent in 2006 and the in-hospital mortality rate decreased from 14.6 percent to 10.1 percent.
Further, between 1994 and 2006, the mortality rate among women 55 and under who suffered a heart attack dropped an incredible 52.9%. For men in that same age group the drop was 33.3%. According to the author of the mortality study that determined those latter figures: “It appears that risk factors, which may be controlled through prevention efforts, are very important in driving these mortality reductions.”
Given those figures, it is hard to argue with the success of cardiologists who sit on the forefront of heart care and heart disease prevention – unless, of course, you are a government bureaucrat.
Rather than pouring more dollars into an obviously successful branch of medicine that is saving lives (the ultimate purpose of health care?), the Obama Administration is going ahead with a plan to cut nearly $1.5 billion from Medicare payment to cardiologists. Obama is doing so by such devices as literally eliminating reimbursement for certain services and/or reducing the amount they will pay for others. Case in point, cardiologists have been able to bill for an extended first visit with Medicare patients to get their history and to recommend a course of treatment. As of January 1, 2010 – no longer.
As a lawyer, I can tell you that the first visit with a new client is essential to obtaining an understanding of the needs and concerns of a client. In my case, I can tell you that almost all of the time, those clients know exactly what has happened to them, i.e. they have been sued or not been paid or had an obvious accident. Nevertheless, it takes time, at least an hour if not more, to truly understand the needs of a new client – and lawyers are not saving lives.
Cardiologists, on the other hand, who do save lives – have to deal with new patients who symptoms are far less defined than a client that has had a specific event happen to them. Indeed, how many people truly know how to describe their medical condition to a doctor? Especially for something as serious and as difficult to understand as their overall heart health? Most people are not that articulate on the subject and that is why it takes at least as much time for a cardiologist, as it would a lawyer, to meet and confer and make recommendations to a first time patient – it is that process which is part and parcel of cardiologists success, i.e. “risk factors . . . controlled through prevention efforts.”
Incredibly, Medicare has decreed that cardiologists will no longer be paid for more than twenty minutes for that essential service! Just twenty minutes to meet a new patient; discuss their medical history, their life-style, their symptoms, to transcribe it all and to make recommendations. You heart, your life, twenty minutes.
When you combine that with massive reductions in payment for other care from cardiologists – so low that such care would have to be delivered at a loss by many cardiologists (for those that stay in business) – you may just have the ultimate government rationing of care – a panel of bureaucrats determining who gets what essential care, i.e. a kind of death panel. After all, can anyone seriously argue that once these cuts are put in place In January, that the gains of cardiologists’ in savings lives, at the very least, will be slowed if not reversed?
Keep in mind that it has been said by the Democrats that Medicare is the model for the coming Obama Care. While I understand that choices have to be made, this terrible decision made by bureaucrats may just be as serious as the heart attacks they are no longer interested in preventing.
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