Back to Basics

Did the Senate forget they are supposed to be representing the American people and are not on the TV game show “Let’s Make a Deal”?  The health care bill has serious, life-threatening consequences and they are putting their votes up for auction – going to the highest bidder.  Are the rest of the Senators wishing they held out for what was behind door number 3?

It is one thing to hold out to negotiate for a change or addition to a bill that will equally impact all people.  It is quite another to hold out and gain an advantage for only your state.  This bill is loaded with special considerations for a number of states and people.  Nebraska and Louisiana received special funding for their votes.  The tax on Cadillac insurance policies no longer applies equally to all policies; if you are in a certain field of business you will be exempt.  These are only a few.  I’m just not quite understanding the new bill writing system of applying only parts of the bill to some states or some people, while others are exempt, and yet others get special advantages.  Special interests are blaring obvious in this bill.

This got me to thinking of days long ago around this time of year when salesmen used to give gifts to the businessmen who had supported their companies.  Simple gifts, such as fruit baskets, a bottle of alcohol, or tickets to a sporting event.  These were all considered thank you gifts.  But alas, the days quickly ended when these “gifts” became a controversial issue and were then viewed as bribes or kickbacks.  Could one be sure the contract given to company A wasn’t because they gave a fruit basket to some manager who could influence that decision?  The gift giving and acceptance quickly ended with reputable companies for fear of being fired or having criminal charges brought upon them for participating in bribes and kickbacks.  Many scandals resulted from these gift exchanges.

So what makes the deals currently being made in the Senate any less criminal?  Didn’t Senator Ben Nelson actually take a bribe or kickback in exchange for his vote?  He negotiated and accepted a deal that gave a monetary advantage to his state, at the expense of the American taxpayer.  Should we not start holding these people accountable and charging them with the criminal activity they are so blatantly participating in?  The persons offering the bribe/kickback, as well as the person accepting the bribe/kickback, should both be criminally charged for their actions.

If I stood outside a polling place and offered to pay for people to vote a certain way, I am sure I would be quickly stopped, arrested and charged with a crime.  Are the Senators not doing the same thing?  Like I said before, it is one thing to negotiate a provision that will equally affect all.  It is quite another to sell your vote.  It’s time to hold them personally responsible.

By Tom Coburn

Published in Wall Street Journal, Dec. 16, 2009

I recently suggested that seniors will die sooner if Congress actually implements the Medicare cuts in the health-care bill put forward by Senate Majority Leader Harry Reid. My colleagues who defend the bill—none of whom have practiced medicine—predictably dismissed my concern as a scare tactic. They are wrong. Every American, not just seniors, should know that the rationing provisions in the Reid bill will not only reduce their quality of life, but their life spans as well.

My 25 years as a practicing physician have shown me what happens when government attempts to practice medicine: Doctors respond to government coercion instead of patient cues, and patients die prematurely. Even if the public option is eliminated from the bill, these onerous rationing provisions will remain intact.

For instance, the Reid bill (in sections 3403 and 2021) explicitly empowers Medicare to deny treatment based on cost. An Independent Medicare Advisory Board created by the bill—composed of permanent, unelected and, therefore, unaccountable members—will greatly expand the rationing practices that already occur in the program. Medicare, for example, has limited cancer patients’ access to Epogen, a costly but vital drug that stimulates red blood cell production. It has limited the use of virtual, and safer, colonoscopies due to cost concerns. And Medicare refuses medical claims at twice the rate of the largest private insurers.

Section 6301 of the Reid bill creates new comparative effectiveness research (CER) programs. CER panels have been used as rationing commissions in other countries such as the U.K., where 15,000 cancer patients die prematurely every year according to the National Cancer Intelligence Network. CER panels here could effectively dictate coverage options and ration care for plans that participate in the state insurance exchanges created by the bill.

Additionally, the Reid bill depends on the recommendations of the U.S. Preventive Services Task Force in no fewer than 14 places. This task force was responsible for advising women under 50 to not undergo annual mammograms. The administration claims the task force recommendations do not carry the force of law, but the Reid bill itself contradicts them in section 2713. The bill explicitly states, on page 17, that health insurance plans “shall provide coverage for” services approved by the task force. This chilling provision represents the government stepping between doctors and patients. When the government asserts the power to provide care, it also asserts the power to deny care.

If the bill expands Medicaid eligibility to 133% of the poverty level, that too will lead to rationing. Because Washington bureaucrats have created a system that underpays doctors, 40% of doctors already restrict access to Medicaid patients, and therefore ration care.

Medicaid demonstrates, tragically in some cases, that access to a government program does not guarantee access to health care. In Maryland, 17,000 Medicaid patients are currently on a waiting list for medical services, and as many as 250 may have died while awaiting care, according to state auditors. Kansas, the home state of Health and Human Services Secretary Kathleen Sebelius, faces a Medicaid backlog of more than 15,000 applicants.

Other unintended consequences of the Reid bill could wreak havoc on patients’ lives. What happens, for instance, when savvy consumers commanded to buy insurance realize the penalty is the de facto premium? It won’t take long for younger, healthier Americans to realize it’s cheaper to pay a $750 tax for coverage instead of, say, $5,000 in annual premiums when coverage can’t be denied if you get sick.

What we can expect from the government takeover of our health care is already starting to reveal its deadly intensions.

The H1N1 vaccine, purchased by and controlled by the government, was a promise that couldn’t be kept.  There was supposed to be enough vaccine available for all those who were at risk as well as it sounding like for anyone else that wanted the vaccine.  Since early this year the government was telling the public how much of an epidemic the H1N1 flu was going to be and was encouraging everyone to get vaccinated.  But when the time came to pay up the government fell far short of their promises.

The H1N1 is a separate vaccination from the regular annual flu vaccinations.  The regular flu vaccination is controlled by private industry.  Those vaccinations have been produced, distributed and are available at your doctor’s office or clinic for anyone requesting it.  In fact, my family doctor asked at my annual exam if I wanted to receive the vaccination.

However, the H1N1 is a different story.  The vaccine was purchased and distribution is being controlled by the government.  While they promised to have enough to go around they fell far short.  The government is controlling all quantities of this vaccine, including where the vaccines are to be sent and how much.  It is only being distributed to government sponsored agencies, so your doctor probably didn’t even receive the vaccine.  In order to obtain the vaccination you have to go to a vaccination clinic.  Even then, if you are not considered high risk you may be denied the vaccination.  So by the end of this year’s flu season only 25% of the H1N1 vaccine will have been distributed.  The rationing has already begun.

Then this week I read an article from the New York Times about a government task force deciding mammograms for women are no longer necessary until age 50, and then only every other year.  They further decided that self-breast exams didn’t do any good and should be discontinued.  Their recommendation was between 50-75 mammograms should be done every other year and after the age of 75 they haven’t yet decided.  Could this be because they are embracing the ideas of the Obama Czars – that anyone over 75 isn’t worth the cost of medical treatment because they have served their usefulness in society already?

How many people know of at least one woman who is alive today because of early detection and treatment of breast cancer?  How many others hear of the terrible tragedy other women face when the breast cancer was diagnosed in a much later stage and it had spread to lymph nodes or other parts of the body.  Sure, they may not have died from breast cancer, but they died from cancer initially caused from the spreading of the breast cancer.

The American Cancer Society came out against the task forces finding.  Does the government task force know more about cancer that the American Cancer Society?  Shouldn’t this decision be between the woman and her doctor?  No, this is all about money.  The task force says that testing 1300 women to save one life is worth it, but testing 1900 to save one life isn’t.  This is the government playing God.  I’m sure if that life that could be saved were yours or a close family member or friend anyone would agree it was worth it.  What price do you put on a life?  What right does the government have to establish that price?

Rationing and denial of services is what we all have to look forward to if the government takes over control of our health by the proposed health care reform bill passed by the House and under consideration in the Senate.  This is only a sample of what we have to look forward to in the future.  Having health insurance is one thing – getting the actual care of your health is another.  The government is only promising the insurance  – BUYERS BEWARE!