October 6. The Wall Street Journal has published a warning that the health care restructuring bill is "trying to engineer a 'cheaper' system so that government can afford to buy health care for all--even if the price is fewer and less innovative ways of extending and improving lives."
The paper takes note of the "provision in the Baucus bill that would punish any physician whose 'resource use' is considered too high. Beginning in 2015, Medicare would rank doctors against their peers based on how much they cost the program-- and then automatically cut all payments by 5% to anyone who falls into the 90th percentile or above. ... Since there will always be a missing chair when the music stops, every year one of 10 physicians will be punished if he orders too many tests, performs too many procedures, or prescribes too many drugs--whether or not the treatments result in better patient outcomes. The 5% fine is substantial given that Medicare's price controls already pay only 83 cents on the private dollar."
The paper points out that this rule will impact specialists, like oncologists and cardiologists, and will operate in conjunction with changes in payment methodology that will impose severe cuts in treatment for heart disease and cancer -- because they are among the most expensive ailments to treat.
Also see pieces in the Washington Times: http://www.washingtontimes.com/news/2009/oct/05/the-haunting-of-medicare-clawbacks/ and http://washingtontimes.com/news/2009/sep/25/death-panels-by-proxy/
and a piece by syndicated columnist Nat Hentoff http://www.wnd.com/index.php?fa=PAGE.view&pageId=110710