The WSJ today succinctly illustrates the morass of government healthcare in a Review & Outlook column titled The War On Specialists. In an effort to both reduce costs and increase the number of General Practitioners, the Administration is making some changes to Medicare. To that end our enlightened politicians are taking money away from medical specialists such as cardiologist and oncologist so they have more to pay to General Practitioners.

"The 2010 rules, which will be finalized next month, visit an 11% overall cut on cardiology and 19% on radiation oncology. They're targets only because of cost: Two-thirds of morbidity or mortality among Medicare patients owes to cancer or heart disease."

Think about that concept for a minute. What chronic diseases do you think affect Medicare recipients the most? Why would one de-fund the very specialties that are needed the most by recipients? The reason for these cuts offered by Administration is "cost savings" but one could reasonably ask if Alan Grayson's attack wasn't directed at the wrong party! Who needs death panels when the government forces cardiologist out of the program by paying them less while at the same time reducing what Medicare will pay for tests like echocardiograms by 42% making them much less likely to be used.

"The way Medicare works is that Congress decides each year how much it wants to spend on doctors, period. If one area of medicine receives a larger slice of this pie, another must accept a smaller one. The portion sizes are determined using a formula known as Relative Value Units, or RVUs. Medicare assigns an RVU to each of 7,500 billable services-in 2008, a colonoscopy earned 5.64 of these units, a hip replacement 37.66. Then it multiplies a doctor's total RVUs by some dollar factor, currently about $36, and cuts a check."

This plan has some major flaws;

The capricious annual pin the tail on the doctor game will discourage good students from pursuing the medical specialties or medicine at all. We already have a shortage of qualified medical personal and these actions will merely exacerbate the situation

It punishes specialties and Doctors that rely on new technology and new drugs which are inevitably more expensive. Medicare currently doesn't pay for the cost of care that it's patients receive now. Further cutting costs in these expensive fields will force more specialist out of the Medicare program which will inevitably lead to shortages for those services among Medicare patients.

It discourages medical innovation and increases costs of new procedures by reducing the pool of patients that can recieve such procedures.
It increases the cost of private insurance because the doctors that remain in Medicare will have to raise the rates for their non Medicare patients to cover their actual costs.

When President Obama complains about the fact that some insurance companies make a profit - remember that it is those insurance companies that are helping foot the bill for the failed "public option" known as Medicare/Medicaid. The system that is being established doesn't reward a success or even measure it in human terms. The only thing that matters is the bottom line, the dollar cost to the politicians in Washington.

There is no free lunch, no matter what the politicians say. Albeit imperfect, our current system is vastly superior to a single payer system because quality care is still rewarded and the medical consumer has a choice. The citizens of this country wouldn't accept a one party political system, why would they consider the equivalent for their healthcare? A single payer system is tyranny with a fancy name.