When Cost Control Means Less Access to Care
This is from USA Today:
A proposal buried in some versions of health care legislation that would reduce Medicare payments to doctors offering scans in their offices…..
Groups lobbying against the change say paying doctors less for performing tests in their offices 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.
It’s interesting how lawmakers often don’t seem to appreciate that their actions often result in unintended consequences. Their simplistic reasoning is: if physician-owned diagnostic imaging centers result in too many unnecessary referrals, then reduce payments to nonhospital-based scanners. But, many freestanding diagnostic imaging centers charge a “cash” price that’s as little as $600 for an MRI compared to hospital-based scans that can be $3,000 more expensive. It’s not the presence of doctor-owned scanners that cause the problem; it’s the lack of competition for seniors’ health care dollars. Let seniors control more of their own (Medicare) dollars and they will find the $600 MRI deal – or get a second opinion to determine they don’t necessarily need the MRI in the first place.
This is one of those times where we can agree that the policy proposal is flawed. By removing tests from on-site, costs across the board go up. Patients spend more time traveling to testing sites and less time working. Simplicity is needed here. The answers to healthcare are often portrayed as being to complex or convoluted. The truth remains that the best answers are those that are simple, straightforward, and to the point.
Yet the AMA endorses it, like a lamb to slaughter.
Removing incentives from doctors to provide better coordinated care is the opposite of the National talking points being used to sell the policy ideas.