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Kennedy: Let’s Ration Health Care

By: William Kristol
Weekly Standard
07/20/09 7:21 AM EDT

Newsweek Managing Editor Daniel Klaidman explains that his magazine decided to ask Sen. Ted Kennedy to author a cover piece on health care, because “his absence during this historic debate had been so palpable, yet here was a way for this respected voice on health care to weigh in and be part of the national conversation at a critical moment.”

Well, Sen. Kennedy has weighed in, and he may have helped doom Obamacare.

For Kennedy and his co-author, Bob Shrum, have let the rationing cat out of the bag. And that’s a problem for President Obama and the Democrats. Make no mistake: Beyond all the other crippling problems with the Democrats’ health care proposal--its cost at a time of massive deficits, the tax increases it requires at a time of recession, its preference for government over the private sector and for central planning over free competition--the deepest vulnerability of Obamacare is that it (intentionally) puts us on a course towards government rationing of health care.

Here’s the key paragraph from Kennedy and Shrum:

We also need to move from a system that rewards doctors for the sheer volume of tests and treatments they prescribe to one that rewards quality and positive outcomes. For example, in Medicare today, 18 percent of patients discharged from a hospital are readmitted within 30 days--at a cost of more than $15 billion in 2005. Most of these readmissions are unnecessary, but we don't reward hospitals and doctors for preventing them. By changing that, we'll save billions of dollars while improving the quality of care for patients.
Now first of all, if there are problems with Medicare, the laws and regulations governing Medicare--a government program--can be changed, without a government take-over of the rest of the system. Second, given that first diagnoses are often wrong or that hospital treatments lead to unanticipated complications, it’s not so clear on the face of it that an 18 percent readmission rate within 30 days for elderly patients is unreasonable. And third, even if the whole $15 billion worth of hospital readmissions were unnecessary (which can’t be case), $15 billion per year is less than 1 percent of our health care spending.

But the most important implication of the Kennedy-Shrum claim--“Most of these readmissions are unnecessary, but we don’t reward hospitals and doctors for preventing them. By changing that, we’ll save billions of dollars.”--is this: The government is going to decide--ahead of time, obviously, since deciding after the fact wouldn’t save any money; and based on certain general criteria, since the government isn’t going to review each individual case--what kinds of hospital readmissions for the elderly are “unnecessary” and what kinds aren’t. And it’s going to set up a system “to reward hospitals and doctors for preventing” the unnecessary ones. That is, the government will reward hospitals and doctors for denying care they now provide, care the government will now deem “unnecessary.”

Indeed, this understates the case. For in reality the government isn’t going simply to reward “good” and penalize “bad” admissions. It’s going to prevent insurance companies from paying for “unnecessary” admissions and procedures, if those companies want to participate in the government system. In other words, government bureaucrats are going to deem entire categories of treatment inefficient for all or certain categories of patients, and put those treatments out of bounds for doctors and hospitals.

There are problems aplenty with our current health insurance and health care system. But do the American people want this kind of reform, one that has at its center an expansion of government control and one that leads, according to its own logic, to government rationing and denial of health care?
--Cross-posted at The Weekly Standard Blog.



 

 




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Reader Comments

All comments on this page are subject to our Terms of Use and do not necessarily reflect the views of the Examiner or its staff. Comment box is limited to 250 words.

mary

Jul 19, 2009

I think we should ration healthcare, as long as we start with TED kENNEDY!

 

rk

Jul 19, 2009

One of the major trends over the last 20 years has been to shorten hospital time. No, not because insurers are evil, not because Drs. are so stupid that they release only to readmit...but because hospitals have germs. Many people heal better at home. Sometimes they have to be re-admitted.

The arrogance of these people is stunning. Their need for power is a stench on the nation.

 

John

Jul 19, 2009

Being a physician and admitting patients to hospitals, the reason for the hight re-admission rate is simply that most of these types of patients have incurable and chronic diseases invariably deteriorate with time. An old patient with a failing heart gets readmitted more and more frequently, as there is no way to prevent the further deterioration of his heart, and yet patients expect ongoing care. The same can be said of chronic lung disease or malignancies; unfortunately, hospitals have the technology to keep these patients going and that is why these patients keep coming back to the hospital. To punish doctors and hospitals for doing what they are trained to do would be the ultimate crushing blow to our profession.

 

ColonialAmerican1623

Jul 19, 2009

OMG...what a bunch of hypocrites.
Congress has excluded themselves from
healthcare reform.
Think about this..uninsured and unemployed Americans are paying taxes so that everyone from the President to Kennedy to a federal employee to that illegal alien swimming across the Rio Grande to have an Anchor baby can have healthcare that they cannot access.
If Kennedy thinks the elderly shouldn't have care, let's start with him since my tax dollars are paying for his care.
He thinks nothing of having the best possible care in the country on our dime.
Re-elect no one. Thow these scumbags out on their can. Enough already.

 

iain

Jul 20, 2009

why not just cap malpractice awards so that doctors can practice prudent medicine without having to pay outrageous premiums to insurance companies? Currently doctors are regularly second guessed after the fact by lawyers... oh, wait a minute, the law makers ARE lawyers...

 

Jul 20, 2009

Is it really a true fact that Congress, federal employees, and the unions will be exempt from this "new health coverage?" Also, has anyone run the numbers to see exactly how much money will go into the insurance pot by taxing those who make over $250,000. I understand that often the wealthy have so many "deductions" they often don't pay as much as the middle class taxypayer.

 

bobc

Jul 20, 2009


Congress prohibits Medicare patients from paying cash to receive treatment denied by Medicare – unless the doctor agrees not to take Medicare payments for two years.

Citizens who refuse to sign up for Medicare Part A (hospitalization) lose all Social Security benefits. Citizens who disenroll must repay benefits received.

Congress is paying Medicare HMOs (Medicare Advantage) 18 percent more per senior than what is paid through traditional Medicare, perhaps to entice seniors to HMOs.

Congress has begun paying Medicare bonuses to doctors who comply with government and HMO treatment directives.
http://www.cchconline.org/issues/medicare.php

 

FireInsideTheMan

Jul 20, 2009

Medicare, like most national welfare programs, has become a bloated, inefficient program that wastes Billions of hard-earned taxpayer money.

Don't be fooled by all the audacity of hype promised by Obama and his cronies. True health care reform does not require government mandates, but rather private enterprise with forward-thinking individuals making better choices for themselves and their communities.

 

flicka

Jul 20, 2009

Absolutely lets start rationing care with Kennedy, then move onto Byrd, then Ginsberg, and then all the old and sick liberals who WANT rationed care. Let us all start with them and watch what happens and then see if that's what will work for the rest of us- come on, let us be SCIENTIFIC about these experiments!

 

trhug

Jul 20, 2009

Soon it will be over for people like me. I am retired, disabled, and have three doctors that I see quarterly for maintenance. Fortunately, I have already paid for burial expenses. With gov care(socialized medicine) elderly people will be culled as too expensive. One should remember if he lives long , he or she will be elderly too.Most societies are rated by their care for and about sick , underprivelidged, and elder people. If Congress passes this bill , we as a people are destined for third world status and eventual social chaos as in Cuba, Russia, Iran , etc...ad infinitum. I expect civil disobedience to result when all citizens realize what has begun to transpire. Get your soul ready for eternity, if you live long you will die! NO EXCEPTIONS
GLH

 

Carolyn

Jul 21, 2009

Exactly, what kind of health insurance does Ted have? HE HAS AND CONTINUES TO RUN US A FORTUNE.Does he even know how much his care has cost the taxpayers, or the insurance company? That is something a reporter should track and print.He is TOO, TOO old for so much help, and if he is so committed to this rationing, he should have turned all help down to be an example.
Personally, I would like to sue -or put on the rack-the doctors who helped him.
They should know better.

 

Jose

Jul 21, 2009

The answer is TERM LIMITS, kick them all out and what ever goes is good for the goose and they are the gander

 

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