Last week’s disclosure that MediCare will now gladly reimburse doctors for annual chats with patients re: the desirability calling it a day and heading for heaven has revived the death panel uproar.
Why?
First, to put the flap in context: ObamaCare doesn’t fundamentally restructure healthcare delivery … it just rearranges the flow of money and patients.
- Folks who are already covered by insurance plans will pay higher premiums to cover the costs of folks on the margin who were previously denied coverage (pre-conditions, adult children)
- Healthy folks (mostly young adults) who previously opted to self-insure (i.e. to not buy insurance because they are health & cocky and conclude that they don’t need health insurance), will be forced to buy insurance that they will underutilize (because they are healthy) … to subsidize high cost, unhealthy insurance plan members (who will take out more than they put in).
- Healthcare will be throttled to old folks –- who consume a lot of healthcare in their last years — to save MediCare $$$ that will fund healthcare for the folks who are currently uninsured.
The current uproar revolves around the latter provisions.
While end of life consultations don’t really represent death paneling, they are a significant step in that direction — they are a form of soft rationing that – in concept — allows patients to voluntarily opt out of end of life medical services.
Some argue that’s a slippery slope.
What if doctors are incentivized by the Feds to skew the conversations towards terminal strategies? Or, what if doctors are incentivized to hush-up available life prolonging options?
Then, the soft rationing begins to harden.
Can you imagine the Feds incentivizing doctors to promote terminal treatment options or the gov’t refusing to reimburse for near end of life procedures for certain ‘unworthy’ patients. Hmmm.
To some people, that starts to sound like death panels.
And, that’s why there’s an uproar.
The Homa Files 
January 3, 2011 at 12:34 pm |
I’ll take the bet on point three: “Healthcare will be throttled to old folks”
Does anyone believe that the inflation adjusted dollars per Medicare patient will be lower five, ten years from now? Not me. We are going to enter a golden age of spending on health care for old people. They got the votes, care is getting more expensive, people seem more willing to pay for elder care than other govt functions.