December 24, 2009

Collectivism in the Heath Care Bill

I know you're all shocked. Stick with me a minute.

In a superb guest editorial in the WSJ, Dr, Scott Gottlieb provides a comprehensive enumeration of reasons that the current Senate bill is bad for physicians and providers. Most will not be a surprise, but I had not seen this little gem before:

Next, the plan creates financial incentives for doctors to consolidate their practices. The idea here is that Medicare can more easily apply its regulations to institutions that manage large groups of doctors than it can to individual physicians. So the Obama plan imposes new costs on doctors who remain solo, mostly by increasing their overhead requirements—such as requiring three years of medical records every time a doctor orders routine medical equipment like wheelchairs.

The plan also offers doctors financial carrots if they give up their small practices and consolidate into larger medical groups, or become salaried employees of large institutions such as hospitals or "staff model" medical plans like Kaiser Permanente. One provision, laid out in Section 3022, allows doctors to share with the government any savings to the government they achieve by delivering less care—but only if physicians are part of groups caring for more than 5,000 Medicare patients and "have in place a leadership and management structure, including with regard to clinical and administrative systems."

Round 'em all up so they are easier to control! These are Doctors we are talking about.

Consolidation has a great track record in business and is important. But no serious person ever claimed it improved innovation. Our new medical overlords are so considered somebody will discover a new treatment that costs money.

Health Care Posted by John Kranz at December 24, 2009 1:55 PM
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