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<FONT face=Tahoma size=2><B>From:</B> nrlc@nrlc.org [mailto:nrlc@nrlc.org]
<BR><B>Sent:</B> Friday, September 18, 2009 2:14 PM<BR><B>To:</B> Art
Kelly<BR><B>Subject:</B> "Death Spiral" Rationing in Baucus
Bill<BR></FONT><BR></DIV>
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<DIV><FONT face="Trebuchet MS"><B><U><FONT size=2>For immediate
release:</FONT></U><FONT size=2> <BR></FONT></B><FONT
size=2>Friday, September 18, 2009</FONT></FONT>
<P><FONT face="Trebuchet MS"><B><U><FONT size=2>For more
information:<BR></FONT></U></B><FONT size=2>Derrick Jones, (202)
626-8825 </FONT></FONT><SPAN style="FONT-FAMILY: Trebuchet MS"><FONT
size=3><O:P><BR></O:P></FONT></SPAN><FONT face="Trebuchet MS"
size=2><SPAN style="LETTER-SPACING: -0.2pt"><A
title=mailto:mediarelations@nrlc.org
href="mailto:mediarelations@nrlc.org"><FONT
title=mailto:mediarelations@nrlc.org
color=#0000ff>mediarelations@nrlc.org</FONT></A></SPAN>
</FONT></P></DIV></DIV><TITLE="HTTP:
NRLCmemoHydeAmendmentWillNotApply.html? AHC www.nrlc.org>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center"
align=center><FONT face="Trebuchet MS" size=4><B><SPAN
style="TEXT-TRANSFORM: uppercase; COLOR: black">"Death Spiral"
Rationing in Baucus Bill Gravely<BR>Endangers <ST1:COUNTRY-REGION
w:st="on"><ST1:PLACE
w:st="on">America</ST1:PLACE></ST1:COUNTRY-REGION>'s
Seniors</SPAN></B></FONT><SPAN
style="TEXT-TRANSFORM: uppercase; COLOR: black; FONT-FAMILY: Arial"><O:P></O:P></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><SPAN
style="COLOR: black"><FONT face="Trebuchet MS" size=2><BR><ST1:STATE
w:st="on"><ST1:PLACE w:st="on">WASHINGTON</ST1:PLACE></ST1:STATE> –
The health care bill proposed by Senate Finance Committee Chairman
Max Baucus on September 16 contains a dangerous provision that
creates a financial incentive for Medicare doctors to deny
treatments to seniors.<BR><BR>National Right to Life Executive
Director, David N. O'Steen, Ph.D, says, <B>"This is the cruelest and
most effective way to ensure that doctors are forced to ration care
for their senior citizen patients. It takes the telltale
fingerprints from the government: instead of bureaucrats directly
specifying the treatment denials that will mean death and poorer
health for older people, it compels individual doctors to do the
dirty work. It is an outrageous way to provide coverage for the
uninsured - by taking it away from <ST1:COUNTRY-REGION
w:st="on"><ST1:PLACE
w:st="on">America</ST1:PLACE></ST1:COUNTRY-REGION>'s senior
citizens."</B><BR><BR>The provision penalizing doctors establishes
that for at least five years, Medicare physicians who authorize
treatments for their patients that wind up in the top 10% of per
capita cost for a year will lose 5% of their total Medicare
reimbursements for that year [see footnote 1 at bottom of release].
<O:P></O:P></FONT></SPAN></P>
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style="COLOR: black"><O:P><FONT face="Trebuchet MS"
size=2></FONT></O:P></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT
face="Trebuchet MS"><SPAN style="COLOR: black"><FONT size=2>This
means that all doctors treating older people will constantly be
driven to try to order the least expensive tests and treatments for
fear that they will be caught in that top 10%. It is noteworthy that
this feature operates independently of any considerations of
quality, efficiency, or waste - if you authorize enough treatment
for your patients, however necessary and appropriate it may be, you
are in danger of being one of the 1 in 10 doctors who will be
penalized each year. Moreover, it creates a moving target - by
definition, there will ALWAYS be a top 10%, no matter how far down
the total amount of money spent on Medicare is driven.
<BR><BR><B>“It's like a game of musical chairs, in which there is
always one chair less than the number of players – so no matter how
fast the contestants run, someone will always be the loser when the
music stops,”</B> O’Steen added.<BR><BR>The incentive this creates
is purely cost-driven, without any balancing of benefit. It will
create a constant sense of uncertainty in doctors, since none can
know in advance precisely what the cutoff for a given year will be -
resulting in still more pressure to limit treatment and diagnostic
tests to the bare minimum.<BR><BR>For more information:
</FONT><A
title=http://www.mmsend3.com/ls.cfm?r=166824244&sid=7457287&m=821785&u=NRLC&s=http://powellcenterformedicalethics.blogspot.com/
href="http://www.mmsend3.com/ls.cfm?r=166824244&sid=7457287&m=821785&u=NRLC&s=http://powellcenterformedicalethics.blogspot.com/"><FONT
title=http://www.mmsend3.com/ls.cfm?r=166824244&sid=7457287&m=821785&u=NRLC&s=http://powellcenterformedicalethics.blogspot.com/
size=2>http://powellcenterformedicalethics.blogspot.com</FONT></A><FONT
size=2> </FONT></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"> </P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT
face="Trebuchet MS" size=2><B><SPAN
style="COLOR: black">Notes:</SPAN></B></FONT><SPAN
style="COLOR: black; FONT-FAMILY: Arial"><O:P></O:P></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.5in"><SPAN
style="COLOR: black"><FONT face="Trebuchet MS" size=2>1. On pages
80-81 of the 8.16.2009 Chairman's Mark, in the "Expansion of
Physician Feedback Program" in Title III, Subtitle A, Part I;
specifically, at the top of page 81: "Beginning in 2015, payment
would be reduced by five percent if an aggregation of the
physician's resource use is at or above the 90th percentile of
national utilization. After five years, the Secretary would have the
authority to convert the 90th percentile threshold for payment
reductions to a standard measure of utilization, such as deviations
from the national mean."<BR><BR>The Congressional Budget Office
(CBO) rates this as taking $1 billion from Medicare payments over a
period of 6 years. See CBO 9/16/09 letter to Chairman Baucus, Table,
page 3 of 7.<O:P></O:P></FONT></SPAN></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B><SPAN
style="COLOR: black"><O:P><FONT face="Trebuchet MS"
size=2></FONT></O:P></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><I><FONT
face="Trebuchet MS" size=2>The National Right to Life Committee, the
nation's largest pro-life group is a federation of affiliates in all
50 states and 3,000 local chapters
nationwide. <O:P></O:P></FONT></I></P>
<P class=MsoNormal><B><FONT face="Trebuchet MS" size=2><A
href="http://www.nrlc.org">www.nrlc.org</A></FONT></B></P></DIV></FONT>
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