NCPA - National Center for Policy Analysis


September 18, 2009

President Obama has yet to spend any time rebutting the central critique of his health care proposal: his inability to provide quality medical care for 30 million new patients without additional doctors or nurses, says Dick Morris, a former adviser to Sen. Trent Lott (R-Miss.) and President Bill Clinton.

The shortage of medical personnel that will inevitably accompany the expansion of the patient population will leave people without adequate care.  Higher demand without extra supply will mean rationing, which will take its greatest toll on the elderly, forcing them to forgo elective surgery or do without life-prolonging treatment.  We will all wait longer for care we now receive on demand, explains Morris.

President Obama will cut Medicare and that portion of Medicaid which serves the elderly in nursing homes (75 percent) in two ways, says Morris.  First, he will cut "hundreds of millions in waste and fraud and unwarranted subsidies in Medicare," as determined by an executive branch commission, but largely in the form of lower payments to hospitals and doctors:

  • Paid less, doctors will spend less time on each patient.
  • Reimbursed less for MRIs or CT scans, they will order fewer of them.
  • Getting less income, more doctors will retire and fewer will enter the profession, aggravating scarcity.

Secondly, his newly established panel to cut Medicare will also encourage the adoption of "common-sense best practices by doctors and medical professionals."  According to Obama, the resulting reduction in waste and inefficiency in Medicare and Medicaid will pay for most of his reform plan. However:

  • These are code words for rationing, says Morris; the panel will encourage doctors to adopt the best practices the panel recommends by limiting reimbursement rates or banning alternatives.
  • Likely guidelines will govern who can get elective surgery like hip replacements or new knees based on the number of quality adjusted remaining years the patient has.

The president's plan is, essentially, a program to take medical care away from the elderly and give it to those who are younger, healthier and, in the main, richer, says Morris.

Source: Dick Morris, "Obama's Unhealthy Speech," THE HILL, 09/15/2009

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