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Death by a Thousand Cuts

Editor’s note: Can you feel the goring yet? The following is an article about one of the provisions in the proposed health care bill. Reducing the cost of health care — isn’t that a good thing?

Well it appears that Congress will do it in the way they always have by reducing reimbursements. This MRI article is just one example.

Does this begin to sound like the HMO era returned?

Rather than driving the reduction based on quality measures, evidence based medical guideline (which are all hard work), Congress will take nearest blunt instrument and reduce costs, create unintended consequences and impact our ability to get quality health care.


Battle Looms Over Funding Cuts for MRIs

USA Today
John Fritze

July 17, 2009

As Congress debates a sweeping overhaul of the nation’s health care system, a battle is brewing over one provision that could affect the availability of MRIs and other tests, particularly in rural areas.

A coalition of physicians and companies that make medical imaging equipment is lobbying lawmakers to reverse a proposal buried in some versions of health care legislation that would reduce Medicare payments to doctors offering scans in their office.

President Obama and some Democratic lawmakers say the cuts will curtail overuse of MRIs, CT scans and other imaging tests. Opponents counter that some physicians could be forced out of the testing business, reducing access for everyone — including patients with private insurance.

“It’s something that’s going to affect patients dearly, I’m afraid,” said Steven Harms, a radiologist at the Breast Center of Northwest Arkansas. “There are a lot of small towns (where doctors) are doing CTs and MRIs, and I don’t think they’re going to be able to stay in business.”

Medicare spending on imaging tests in doctor’s offices cost $14 billion in 2006, more than double the amount in 2000, according to a Government Accountability Office study. The volume of imaging ordered for Medicare patients in doctor’s offices grew 44% between 2002 and 2007, an independent congressional agency found.

Groups lobbying against the change say paying doctors less for performing tests in their office will make the practice unaffordable for some. If they shut down their in-house machines, doctors would send patients to hospitals that, in rural areas, could be miles away, or that, in large cities, could require long waits.

“We’re concerned about how it will affect access to care and the availability of those services, particularly in low-income communities,” said Jack Lewin, chief executive officer of the American College of Cardiology. “Places that are already on the fringe of saying, ‘We can’t quite afford this service,’ drop off.”


July 17, 2009 - Posted by | Cost, Federal Government, healthcare | , , ,

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