The bill unveiled today by Sen. Max Baucus (D-MT) contains important elements that would greatly impact the ability of patients to receive unrationed medical care.
With respect to rationing, the proposal contains a Medicare provision that, beginning in 2015, would severely financially penalize physicians who are in the top 10% of medical resource use. This provision does not link funding to outcomes or quality; instead, it will force a "race to the bottom" with relentless pressure on doctors to limit health care for their older patients. On top of the significant Medicare cuts in the bill, this will gravely endanger the lives of America's senior citizens.
The bill does contain language to prevent the use of comparative effectiveness analysis in a manner that would discriminatorily deny treatment because of age, disability, or terminal illness; however, this language would not affect the financial incentive to ration care as described above.
There are other places in the bill where the Secretary of Health and Human Services is given discretion to regulate the treatment that healthcare providers can give to their patients. Please check back soon for further analysis.