Unintended Consequences Of Federal Health Care Rule
From the “Reasons Not To Put Government Bureaucrats In Charge Of Health Care” file comes this from — of all places — the New York Times.
A shift last year by the federal government in how it pays for drugs to treat dialysis patients may have had an unintended and potentially dire consequence, according to new research: a significant jump in blood transfusions for patients who now may not be getting enough of the medications.
And now, thanks to federal bureaucrats making a small change in the rules, we have some serious medical issues for the patients.
Previously, the government had paid dialysis centers for these drugs separately from the actual blood-cleansing treatments, effectively encouraging their overuse. That created health hazards, as well, because the high red blood counts produced by overuse of the drugs carry a heightened risk of heart attack and stroke.
So the federal Medicare program, which covers the treatment of life-threatening renal conditions, regardless of a patient’s age, changed its payment system to reimburse for overall care, bundling together the cost of treatment and drugs. For the dialysis centers, that instantly transformed the expensive drugs from a profit center to a drain on profits.
The new research, to be presented Friday to a meeting of the National Kidney Foundation in Washington, found that dialysis clinics were prescribing less of the drugs, as the government intended. But the transfusion numbers suggest that dialysis providers, driven by the revised incentives and new usage guidelines, have yet to find the right medication level for some patients.
According to the United States Renal Data System, in each of the first nine months of 2011, the share of dialysis patients covered by Medicare who received blood transfusions increased by 9 to 22 percent over the corresponding months in 2010. Last September, for instance, there were 10,041 transfusions for dialysis patients, compared with 8,259 for the same month in 2010. There had been virtually no change in transfusion rates between 2009 and 2010.
Note, please, that rather than trust the doctors, nurses, and other trained health professionals actually administering the treatment to the patient and then judging the effectiveness of that treatment, the government paper-pushers decided to make a blanket rule for all patients in all cities across the nation that, in essence, tossed the baby out with the bathwater. And the results speak for themselves.
The implications can be foreboding for patients awaiting kidney transplants because transfusions, along with pregnancies and prior transplants, can change body chemistry and make it more difficult to find a compatible organ. That makes them more likely to be among the 4,500 Americans who die each year while waiting for kidney transplants.
So people could die because of this decision.
Now, if this was a decision made by a private health insurance company, the patient could shop around for a different insurer that would cover the treatment more appropriately. However, because it’s what Ted Nugent aptly calls Fedzilla making the decision, there’s no chance for them to go to a different insurer.
If ObamaCare stands, and we take that big step towards a single-payer system, we’ll have taken a step towards putting these sorts of literally life and death decisions in the hands of these unelected bureaucrats.
That’s why, whether it’s the Supreme Court or Congress and a Republican President doing it, ObamaCare has got to go.