Normal
0

MicrosoftInternetExplorer4

st1:*{behavior:url(#ieooui) }

/* Style Definitions */
table.MsoNormalTable
{mso-style-name:”Table Normal”;
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-style-noshow:yes;
mso-style-parent:””;
mso-padding-alt:0in 5.4pt 0in 5.4pt;
mso-para-margin:0in;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-size:10.0pt;
font-family:”Times New Roman”;}

Dx: Fear Rx: The Facts about Health Care Reform – Socialized
Medicine

---

by Alta Price, M.D.

(cross posted at Quadsville.com in Dr Dx’s
Blog)

 

HR 3200 is a good bill. It is not a perfect bill. But it is
good enough that a far left progressive (yours truly) and the American Medical
Association (not big on socialized medicine) both support it. You can bet if
the myths about socialized medicine, physician payments, or government
interfering with the practice of medicine were true, the AMA would not approve.
You can read the AMA letter to Charlie Rangel here saying what they like about the bill (that exact expression must have been on
Rep. Rangel’s face when he opened the AMA letter – hehe).

 

Parts of the bill the AMA likes include: expanding the
availability of affordable health care coverage to the uninsured, increased
support for prevention and wellness services, investments in the physician
workforce, and increasing Medicare payments for primary care services without
cutting payments for other services. There are more technical sections in HR
3200 vital to doctors and hospitals about how government plans, like Medicare
and Medicaid, decide what to pay them. You don’t need to worry about these
obscure laws and formulas, until they pay doctors so little they stop taking
Medicare or Medicaid patients or hospitals can’t keep their doors open.

 

The AMA will lobby for some changes to the bill. They want federal
support to states that implement liability reform (i.e., to control the cost of
medical malpractice insurance) and they want to preserve patient access to
physician-owned hospitals.

 

Finally, let’s talk about “socialized medicine”. Socialized
medicine is when the government owns the health care facilities and pays the
doctors’ salaries. The AMA is mightily opposed to this approach. The public
option in HR 3200 in no way sets up this type of system. In our current
government run health care programs like Medicare and Medicaid, hospitals and doctors
are not owned or employed by the government. On the other hand, the VA health
care system is socialized medicine, since the hospitals are owned and
the physicians are employed by the federal government. (And isn’t it ironic
that those anti-reformers most terrified of “socialized medicine” think that
the socialized medicine VA system provides excellent care, better than our
non-socialized Medicare and Medicaid programs?) Other examples of socialism in
the United States
include our public schools, police and fire departments, public libraries, and
postal service.

 

Dr Dx (in the interests of full disclosure, I’ve been an AMA
member for years)

 

****************************************************************

Here are some of the false claims relating to socialized
medicine, physician pay, and physician self-referral made about the House bill,
HR 3200 (you can read the full text of the bill here). The Truth comes from Health Care for America
Now, one of the lead coalition groups
fighting for health care reform.

 

“Page 127: The AMA sold doctors out: the government
will set wages.” 

TRUTH: The government will negotiate rates with providers
under the public health insurance plan option. However, private insurers will
continue to pay their own rates.

“Page 239: Bill will reduce physician services for
Medicaid. Seniors and the poor most affected.” 

TRUTH: This section has nothing whatsoever to do with
reducing services. It makes much needed changes to the way in which
physician reimbursement is recalculated every year. The bill will, in fact,
create much more opportunity for seniors and the poor to receive necessary
care.

“Page 241: Doctors: no matter what specialty you have, you'll all be paid
the same (thanks, AMA!)” 

TRUTH:  Page 241 does not say this. Nowhere does
it say this. It does say that physicians will be grouped into certain
categories regardless of specialty.  These categories merely determine if
the physician is engaged in primarily therapeutic or preventative care.

 

“Page 253: Government sets value of doctors' time,
their professional judgment, etc.”

TRUTH: There is no good response to this assertion as it
appears to have been made up completely. The section deals with 'misvalued
codes' meaning that the government is potentially not paying an acceptable rate
for a specific service. This will allow the government to, for example, pay
more for services that require more payment, such as high-overhead
procedures. The author of these criticisms separately attacks the bill for
paying the same rate to all doctors, then attacks again for paying different
rates.

 

“Page 265: Government mandates and controls productivity
for private healthcare industries.” 

TRUTH: This section amends the Social Security Act to
include productivity measures.  There is no mandate or control of
anything. This merely updates the way in which doctors and hospitals are
paid through Medicare.

“Page 298: Doctors: if you treat a patient during an
initial admission that results in a readmission, you will be penalized by the
government.” 

TRUTH: This is patently false. The section is about
possible methods that the Secretary of Health and Human services might consider
in order to address the growing problem of patient readmission. This section
does not, in any way, create a penalty, nor does it even mandate
policy. It merely provides examples of recourses that might be considered.


“Page 317: Doctors: you are now prohibited from owning and investing in
healthcare companies!”

TRUTH: This provision only limits Doctor's investments in
health care facilities that they refer patients to. The effort to limit
self-referral has been ongoing for many years as an effort to reduce fraud and
abuse.  This is, essentially, the medical community equivalent of insider
trading. Limiting this incentive works to put the patient's health above
all other considerations. Doctors remain free to engage in investment
opportunities in areas that don't create a significant conflict of interest.

“Page 318: Prohibition on hospital expansion. Hospitals cannot expand
without government approval.”

TRUTH: This section regulates physicians' investment in
hospitals to make sure that physicians are not unfairly benefiting from their
power to refer patients to hospitals they have a stake in. The section does not
prohibit hospital expansion.

Dr Dx will be back on Monday.