ObamaCare: The Good, the Bad, the Ugly, and the Ignored – Part 4

In Part 1 of this series I listed things in the house version of ObamaCare (H.R.3200) that I think are conceptually good and also some conceptually bad. Parts 2 & 3 highlighted parts of H.R.3200 that are downright ugly. Part 4 extends the list of the ugly.

The Ugly - Continued
8. Squeezing Hospitals: - Section 1103 requires acute care hospitals, nursing facilities, long-term care hospitals, inpatient rehabilitation facilities, hospice facilities, and psychiatric hospitals to reduce costs annually based on a nation-wide business productivity improvement index. This will motivate these providers to cut corners, reduce services, reduce capital investment (to reduce depreciation expense) and tempt them to reduce the quality of health care overall.

9. Limitation on Physicians’ Services to those Covered in a Fee Schedule: - Section 1121 limits the services for which physicians will be paid by Medicare to a list of specific approved services that are to be detailed on a Physicians Fee Schedule. This is yet another method of preventing doctors from using their own judgment in recommended treatment options to you – the patient.

10. Establishment of Limits on the Rate of Increase in Payments for Services: - Section 1121 establishes a target growth rate in the payment of services. The target will be calculated in a manner that cannot be determined by reading the H.R.3200 but the target will be used to limit payments to providers so that the overall rate of increase in the aggregate payments will rise at a rate less than or equal to the target rate. This will further squeeze payments to doctors, hospitals, and other health care providers forcing them to reduce costs, services provided, and quality of care.

11. “There Shall be NO Administrative or Judicial Review”: - Six times in H.R.3200 groups of decisions to be made by new government agencies established by H.R.3200 are removed from ANY form of review. They will not be subject to review by the courts nor will any administrative body be established to review these decisions – they are absolute.

12. Limitation on Hospital Expansion: - Section 1156 limits, and in some cases prohibits, the expansion in the number of hospital operating rooms, procedure rooms, and beds. The rules applying to these limitations cannot be determined by reading H.R.3200. The effect of such limitations is inevitable rationing by bureaucratic command or by lengthy waits for service.

There’s still more ugly to report in future posts.

Links to Other Topics in the Special Report: Universal Health Care