No one actually proposed death panels as one right wing pundit suggested. Even Ezekiel Emanuel didn't suggest it. Not that I would put it past him (or anyone in this administration) in a home grown totalitarian system. But that's for the future. We are not there yet.
In the meantime, we have a problem. What to do with Grandma? With a soon to be bankrupt Medicare system and an aging baby boomer population, obviously something has to be done.
The new strategy goes something like this. Doctors are the target. Those who administer too many tests, a threshold affected by their elderly case load, will experience cuts in Medicare reimbursement. Yes, there will be some consideration of the elderly case load but tight controls on testing will impose penalties over a certain threshold of testing. Defensive medicine will not be readily tolerated and thorough documentation will be required for each and every test. This, of course, is a disincentive to take on a Medicare patients.
Many will say perhaps the time has come to retire. "My malpractice is rising and I can't readily adjust for the new premiums, which seem to come monthly. There's no tort reform. I cannot afford to maintain a practice with too many older patients. They are sicker, require more tests, and Medicare is scaling back. The paperwork is enormous! I have to hire extra help to handle it. And there is always questions; there is always hassles. I can't deal with this."
I think that I will stop taking Medicare patients and find someone to take over the practice. I can't sell it with too many Medicare patients.
What's poor Grandma to do? Can she afford to pay for a private plan? Can she find even find a doctor? Who will treat her epilepsy, or diabetes, or congestive heart failure etc? Many doctors have retired or have decided to become shoe salesmen.
Nobody will pull the plug on Grandma. We'll just find her dead in her apartment. I don't want your Medicare. I don't want you. I can't afford you. Grandma can only afford Medicare. She couldn't afford a private plan. It didn't make sense for her to pay the tax penalty for going naked with no insurance. There will be additional tax penalties for the use of the ER. The public option? Well, it is not as inexpensive as Medicare and priced somewhat beyond her reach.
So, she died miserably. During her grand mal seizure, she bit through her tongue and bleed to death in a state of asphyxiation. When they finally got into the apartment, they found her in a pool of blood and s***. Who cares? The DC crowd? They voted them selves another pay hike so that they can afford a better health insurance plan than what most have.
Here are the stats from a survey: 12% of doctors have already decided to stop seeing Medicare patients; 39% of doctors will limit the number of Medicare patients that they treat if there are further reimbursement cuts in Medicare; 19% will stop accepting new Medicare patients; 33% will no longer see Medicaid patients.
The trend is clear. Fewer doctors; more limited access; longer waits; higher death rate. It's not our fault that doctors are greedy. It's not our fault that they won't see Medicare patients. It's not our fault that people are dying needlessly. It's like HAL the computer speaking. The 9000 series has never made an error. Its record is perfect, and Obama's judgment is nearly as good as the 9000 series.
How can 51% of Americans be wrong?