The 2010 Healthcare Games

As of today physicians are faced with an across the board 21% cut on Medicare. This is a sword that has been hanging over the heads of physicians for 12 years, and today the sword is falling. Even though I’m married to a doctor and believe that doctors should be paid like lawyers, it’s about time.

Congress passed the cuts in the mid 1990’s as a method to contain escalating medicare cuts. But for 12 years Congress has put off the cuts for a year at a time, and each respite makes next years cuts look even bigger. This scares the politicians from even attempting to cut the entitlement, resulting in another year of theater where Congress pretends the health of the Medicare system is just fine and physicians look at ways to reduce their Medicare patient population.

At a certain point you’ve got to scratch your head and wonder why elected officials are setting the price of a service in the first place. Hadn’t we fought a Cold War to prevent just that – the government takeover of a free marketplace? How different is Congress demanding a 21% across the board cut in Medicare from Hugo Chavez who threatens to jail anyone for raising prices after a currency devaluation?

What’s so ironic that even hardcore Leftist English Lit professors can’t appreciate is the fact that the same group of elected idiots that perform this yearly charade want to take their meddling in the Free Market to another level by taking over ALL of healthcare with the acquiescence of the private insurers. Even the American Medical Association – the group that exists solely to lobby Congress on behalf of medical professionals – supported Obamacare against the wishes of its rank and file.

There are three explanations for the AMA support of Obamacare. First reason: the AMA claims that is supports Obamacare because “All Americans deserve affordable, high-quality health coverage so they can get the medical care they need.” Affordable AND High Quality. It reminds me of the engineering maxim “better, faster, cheaper – pick any two.” With healthcare we can choose just two of three types of care: high-quality, affordable, and timely. What the AMA is proposing is Canada, where waiting for care is the norm.

The second reason, which is more closer to the truth in my opinion, is that the AMA backed Obamacare even when the plan promised $500 billion in Medicare cuts to pay for the expanded coverage. Since the cuts were never expected to be enforced by the Obama administration, the AMA felt that it was a safe bet. In the same way the AMA received guarantees that the immediate threat of Medicare cuts would be permanently removed as part of the health care reform package.

The last reason: professional lobbyists who stay in Washington too long develop a form of Stockholm Syndrome where they empathize with their opponents and forget the needs of those who sent them there (and pay their salaries). Physicians tend to be very liberal socially but very conservative when it comes to finances – especially those in private practice. Politically they tend to vote independent with a slight lean to the Left of Center. The AMA lobbyists are salaried. They don’t have to worry about “eating what they kill” as most practicing physicians do. So it’s easy for them to get caught up in the liberal celebration of Obama and forget that those they are supposedly fighting for are fiscal conservatives.

Senator Jim Bunning’s procedural motion forced the issue of the cuts that would never happen by allowing Congress to recess before an emergency stay in the 21% cut could be enforced. The cuts have been promised for 12 years, and every year Congress holds them off for another year. It’s not surprising that the AMA would expect the charade to continue given Congress’s track record.

The AMA is screaming. “Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them,” said AMA President J. James Rohack, M.D. “It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games.”

Promising $500 billion in cuts to medicare and then saddling our nation with a half trillion dollars worth of treasury bonds is a game too, but the AMA was willing to play that game. Now the game is over and the AMA has lost.

More than likely the Democrats will keep the cuts from biting by overriding Bunnings’ procedural motion this week. However the damage is done. The episode serves as a reminder of how politicians do not belong in control of health care decisions (yes that means in regards to abortion as well) and how much a disaster Medicare has become. It also shows the impotence of an organization that lost touch with those it represents. That statement applies equally to Congress and the AMA.

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