Monday, April 08, 2013

When the state takes over a sector, it turns everyone into greedy scammers

Read this account from the WSJ on how physicians treated patient needs and economics before the intervention of third parties:

A major cause of financial stringency was that there was almost no insurance that covered pediatric care in the office setting. Many pediatricians felt denigrated because the care that they were providing was not regarded as sufficiently consequential to be covered by third parties, as was that of their brethren in internal medicine. Surveys always showed pediatricians to be the poorest-paid of all the specialties.

By current standards, the lack of third-party coverage would be impermissible. But treating patients without insurance meant that I had to give my acute attention to the price of every medical intervention. The costs could have a direct and painful impact on a family's budget. So I had to know the prices for most of the medications I prescribed and of most of the tests I might order. I learned to play for time by waiting, when it was safe to, before ordering an X-ray or a test—and to substitute less-expensive medications for more costly ones wherever possible.


Now compare this to how Oncology clinics are behaving in response to 2% sequester cuts:


By the way, here's one of the big stories in the Washington Post's sequester coverage last week . . .
Cancer clinics across the country have begun turning away thousands of Medicare patients, blaming the sequester budget cuts.
Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially . . .
Doctors at the Charleston Cancer Center in South Carolina began informing patients weeks ago that, due to the sequester cuts, they would soon need to seek treatment elsewhere.
Now, check out this account of the same issue from CBS News. (Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York, is quoted in both stories. )
"We couldn't last for more than three to six months if we were to be in the red on all those drugs that now the reimbursement has gone down on," said Dr. Jeff Vacirca, CEO of Northshore Hematology Oncology.
A one-month course of chemo for one patient could cost $10,000. Medicare reimbursement will now fall about $200 short.
"It's going to be a hardship to patients, their caregivers and really such an increased cost to society and to Medicare in the long run that it makes no sense to me," Vacirca said.
Wait, Medicare is now $200 short in covering a $10,000 treatment, and there's no solution that can be found? There's no way the patients can cover that amount, or the provider can't delay a portion of the billing, or some charitable foundation can make up the difference? The only solution is to stop treatment? Doesn't make any sense, does it?
Kind of fascinating that when Medicare implements a 2 percent reduction, the very first place these Cancer Centers implement cuts is in treatment for the most vulnerable.
The state and its magic money machine literally de-moralizes everything it touches: turning once honorable professionals into manipulative, money grubbing scammers. And with PPACA the politicization and moral infantilization of medicine will be complete.

Turning independent adults into squalling toddlers. It's all so progressive.



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