What Drs. Fear Most About ObamaCare

By Betsy McCaughey

Patient advocate Betsy McCaughey intends to let Congress know what doctors fear most about the healthcare reforms it is considering.

McCaughey, former lieutenant governor of New York, began gathering information about physicians’ concerns when she convened 16 of them in January to discuss healthcare.

One of the doctors, kidney specialist Dr. Richard Amerling of New York’s Beth Israel Medical Center, detailed his concerns during an exclusive interview with Newsmax.TV’s Ashley Martella: “I think the most scary aspect is the loss of physician autonomy. Doctors are literally going to be prevented from treating patients to the best of their ability, to the best of their judgment by what will become guidelines coming from central authority, central committees on what are so called best practices.”

Amerling, whose writings have been published in major newspapers, noted that medicine practiced at its highest level is very individualized and never “prepackaged.”

He also contends that the reform package has a punitive factor.

“Doctors are going to be under the gun to conform to these guidelines under penalty of being paid less. This is the system of payment for performance which is a way of cost control,” Amerling said.

“So the doctors are going to be brought into a system of rationing of care under the guise of pay for performance that will lead them to be forced to provide less than adequate care for some of their patients,” Amerling told Martella.

Medical care will be denied to some of the most vulnerable patients, particularly the elderly, if proposed reforms become law, he said.

“I can also tell you that in my own area of kidney disease, there are already planned cuts in reimbursement for the care of kidney failure patients who are among the most vulnerable patients that exist,” he said.

Amerling is pessimistic about the healthcare plans, saying, “I haven’t seen anything to be happy about in the healthcare reform provisions. . . There’s absolutely no way that good, meaningful reform is going to come out of this Congress because the Republicans who have some good ideas have been completely excluded from the process.”

Doctors have endured the same fate during the deliberations, Amerling said.

“I think we’ve been virtually completely ignored. There have been obviously meetings with the so-called leadership, i.e. the AMA, and the AMA has endorsed what’s coming down without, I believe, full knowledge of what it’s all about. I don’t regard the AMA as speaking for myself and I know that most of my colleagues feel the same way. They have long ago abandoned the role of true leadership of the medical profession, if they ever had one.”

In January, McCaughey made transcripts of the dialogue of all 16 doctors and will take them to Washington to give to members of Congress.

Asked what part of the doctors’ analysis she finds most compelling, McCaughey told Newsmax.TV, “The legislation is going to force doctors to choose between their patients and avoiding government penalties.The stimulus legislation that was signed into law on February 17th of last year provides that doctors will be sent protocols from the government on what is cost effective and appropriate care. They’ll be delivered to doctors electronically on computers and doctors who don’t obey these protocols will be penalized financially.”

McCaughey, who is founder and chairwoman of the Committee to Reduce Infection Deaths, said she’s particularly worried about the elderly.

“The most troubling aspect of this government control over doctors’ decisions is the provisions regarding Medicare, which is eviscerated under the Baucus [Senate Finance Committee] plan, one of the five bills currently making its way through Congress,” she said. “The Baucus legislation literally undoes the protections that have been there in the law ever since 1965 to prohibit the federal government from interfering in the decisions that doctors make for elderly, Medicare-eligible patients.

“Now, for the first time, the secretary of Health and Human Services will have the power, very broad power, to define what kind of care elderly people should get, how much it should cost and to penalize doctors who depart from that agenda,” said McCaughey, whom the business
publication Modern Healthcare lists as one of the 100 most powerful people in healthcare.

Although McCaughey read the entire thousand page-plus House healthcare reform bill, most members of Congress have not. One, House Judiciary Chairman John Conyers, an attorney himself, said he didn’t see any purpose in reading the bill without having two lawyers to explain what it means.

“Well, frankly it is hard work,” McCaughey acknowledged. “It’s disappointing that members of Congress don’t read it. But the answer is to provide short, I suggested 20-page bills to address one legislative issue at a time, 20 pages in clear, simple English.”

Referring to the U.S. Constitution, she noted, “After all, the framers of the federal government created an entire national government in just 18 pages.”

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