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Presidential aspirant Mitt Romney may not have intended that the mandatory health insurance law he signed in 2006 would look like the Obama health law. But the Massachusetts law does a lot more than cover the uninsured (a worthy goal). The law broadens the powers of government to dictate treatment decisions and even interferes in where and how patients die. The result will be a breathtaking shift of decision-making from the doctor at bedside to the state.
The Massachusetts law has come under fire for soaring premiums, now the highest in the nation. A 2011 Beacon Hill Institute study concluded that 18,000 fewer people were employed in the state, because employers required to provide coverage left the state or stopped hiring to avoid the cost. But the cost cutting has begun, and the results are alarming.
Chapter 305 of the 2006 law created councils and regulatory bodies charged with cost-cutting, and after several years they have produced a plan. Here are key components:
Mandatory electronic medical records: All physicians must comply by January 2015 as a condition of keeping their medical license.
Comparative effectiveness: A state board — with unions, consumers, employers and other nonphysicians on it — will synthesize medical research into guidelines and ensure that all insurers and doctors follow them. These guidelines will lay out what care is “medically necessary” and include “how to address individual patient cases and circumstances.” Massachusetts says it and its bureaucrats can make better decisions than highly trained physicians at bedside. (Roadmap to Cost Containment pp. 10, 21,36)
Massachusetts’ End of Life Program: Sec. 41 of Chapter 305 of the Massachusetts law creates an expert panel to deal with how and where people die. The state will launch an aggressive public relations campaign to get hospitals and doctors to encourage palliative care, hospice care, and death at home. In Massachusetts, only 24 percent of people die at home. The state says that is too low. (Roadmap, pp.32,33, 41,90,)
Sometimes a patient doesn’t die at home because the doctor doesn’t foresee that death is imminent. A 2006 Emory University study found that doctors treat patients who are expected to die less intensively than patients who are expected to survive, but often doctors can’t predict who is near the end.
The benefits of hospice care are obvious. But physicians also worry that some patients will break down at the mention of hospice care and lose the will to fight their disease. Ultimately, the question is how involved should government be in how we die, especiall when the goal is to cut costs?.
Ending fee-for-service insurance options: Massachusetts will push patients into “medical homes,” to limit access to costly specialists and diagnostic tests, and substitute nurse practitioners and physicians assistants for doctors.
A 2008 Congressional Budget Office report noted that. if cost control is the priority, medical homes are likely to present the same problems as those HMOs of 20 years ago.
HMOs would withhold physicians’ fees until the end of the year and give it back only to the physicians who met targets for limiting referrals or diagnostic tests. Ultimately, what a doctor prescribed for a patient came out of the doctor’s own pocket at the end of the year, setting up a conflict between you and your doctor. (Roadmap, p. 14)
Perhaps Governor Romney didn’t read Section 305 of the health law he signed, or couldn’t anticipate how it would undermine the doctor-patient relationship.
The Massachusetts cost-cutters claim that care could be cut by 20 percent to 30 percent without doing harm. President Obama’s former budget director Peter Orszag made the same claim to defend deep cuts to Medicare funding.
Don’t believe it. Wherever these cost cutting strategies — the same ones that are in Romneycare and Obamacare — are used, the results are deadly. An important study in the Annals of Internal Medicine (February 2011) based on all hospitals in California shows that seniors treated in hospitals providing more intense care and spending more have a better chance to recover and resume their lives. In fact, 13,813 elderly patients with pneumonia, congestive heart failure, stroke and hip fractures who died at low spending hospitals would have survived and gone home had they received more care. That’s a lesson for Massachusetts and the nation.
Betsy McCaughey, Ph.D., is a former lieutenant governor of New York and author of “The Obama Health Law: What It Says and How to Overturn It.”
As Ben Domenech notes in his Transom, Mitt Romney’s advisors have now advised him to support “a $2 gas tax, a VAT, and open Taliban talks.” Add to that list not repealing Obamacare. Norm Coleman, an advisor to Romney, went on record saying
We’re not going to do repeal. You’re not going to repeal Obamacare… It’s not a total repeal… You will not repeal the act in its entirety, but you will see major changes, particularly if there is a Republican president… You can’t whole-cloth throw it out. But you can substantially change what’s been done.
Altogether, ObamaCare cuts $818 billion from Medicare Part A (hospital insurance) from 2014-2023, the first 10 years of its full implementation, and $3.2 trillion over the first 20 years, 2014-2033. Adding in ObamaCare cuts for Medicare Part B (physicians fees and other services) brings the total cut to $1.05 trillion over the first 10 years and $4.95 trillion over the first 20 years.
These draconian cuts in Medicare payments to doctors, hospitals and other health-care providers that serve America’s seniors were the basis for the Congressional Budget Office’s official “score”—repeatedly cited by the president—that the health-reform legislation would actually reduce the federal deficit. But Mr. Obama never disclosed how that deficit reduction would actually be achieved.
There will be additional cuts under ObamaCare to Medicare Advantage, the private option to Medicare that close to one-fourth of all seniors have chosen for their coverage under the program because it gives them a better deal. Mr. Foster estimates that 50% of all seniors with Medicare Advantage will lose their plan because of these cuts. Mr. Obama’s pledge that “If you like your health plan, you will be able to keep it” clearly does not apply to America’s seniors.
Last year’s Presidentially pardoned turkeys, Apple and Cider, passed away within the year after President Obama pardoned them. Susie Coston, national shelter director of the Farm Sanctuary, a farm animal rescue facility, says that the birds are bred for eating, which makes them fat and prone to heart disease, respiratory conditions, and strained joints. In order to dodge death, she says, the turkeys would need to be on a restrictive diet. Where was the First Lady when the turkeys needed her?
A ruling by the Food and Drug Administration Friday has BANNED! the use of the drug Avastin in breast cancer patients because of a lack of proof that it extends their lives, while causing dangerous side effects. Dr. Manny Alvarez, senior managing health editor of FoxNews.com, said that even though the ruling was expected, it will disappoint many physicians as well as patients. “Clearly by not allowing the use of Avastin for breast cancer you are limiting the options patients have for treatment which will affect the lives of many women,” he said.
Throughout the Obamacare debate, President Obama repeatedly promised, “If you like your health care plan, you can keep your health care plan.” Now, Gallup reports that from the first quarter of 2010 (when Obama signed Obamacare into law) to the third quarter of this year, 2 percent of American adults lost their employer sponsored health insurance. In other words, about 4.5 million Americans lost their employer-sponsored insurance over a span of just 18 months.
This is not what the Congressional Budget Office (CBO) had predicted would happen. Rather, the CBO had predicted that Obamacare would increase the number of people with employer-sponsored insurance by now. It had predicted that, under Obamacare, 6 million more Americans would have employer-sponsored insurance in 2011 than in 2010 (see table 4, which shows the CBO’s projected increase of 3 million under (pre-Obamacare) current law and an additional 3 million under Obamacare). So the CBO’s rosy projections for Obamacare (and even these paint a frightening picture) are already proving false.
Artificial hips and knee manufacturer cuts 5% of its workforce to reduce costs as a result of Obamacare’s fees on medical device manufacturers.
