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An Act of Congress? More Like Multiple Acts of Insanity. - Part II

Written by David McKalip, M.D., Neurological Surgeon

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More Insane Acts by Congress on Health Care

The "Secretary" is mentioned 2500 times in the Reid "Patient Protection and Affordable Health Care Act".  The most common mention is for the Secretary of Health and Human Services who is granted extensive new powers in the bill (along with the Secretary of the Treasury).  The Bill consistently describes creation of a bureaucratic infrastructure to interfere in the patient physician relationship specifically designed to drastically reduce spending on patients prescribed by doctors for their benefit. Coupled with the massive increase in health insurance premiums and taxes, the whole bill is more properly labeled the "Patient Assault and Expensive Health Care Act".

Rationing_CapThe Penalize Doctors into Submission/interfere in patient-physician relationship Act. Section 3007, pg 680. [i] The Government will arbitrarily set a budget for patient care and penalize doctors financially and professionally if they dare to spend more than approved on their patients.  Quality Measures that are valid will be used if "PRACTICABLE" and the Secretary may ignore recommendations of medical societies and arbitrarily use the governments. The Secretary shall set acceptable government spending limits for patient care (rationing goals) also called "efficiency".   There will be payment incentives to those doctors who cut spending on patients and comply with quality measures that have not even been shown to improve outcomes.  Those doctors who refuse to follow the arbitrary budget cap or cookbook medicine protocols to instead serve the best interest of their patients will be penalized.  There shall be no additional funds for incentives.  Penalties on one set of doctors will be used to fund "incentives" for doctors who are "government approved".

(Violates several AMA policies including those on Pay for Performance and recently passed directive to AMA leadership [ii] to actively and publicly oppose such financial penalty schemes). ("AMA to actively and publicly oppose ...•      Redistributed Medicare payments among providers based on outcomes, quality, and risk-adjustment factors that currently do not exist; measurements that are not scientifically valid, verifiable and accurate;"  VIOLATES AMA POLICY PRINCIPLE that medical decisions will remain in hands of patients and that health system reform will be based on freedom" -  AMA 11/9/2009: " Assurance that health care decisions will remain in the hands of patients and their physicians, not insurance companies or government officials")

Avoid High Risk Patients Act - aka report your data or face the consequence ACT. Section 3002, page 652. Doctors who do not report their medical data on meaningless "processs measures" ("best" practices) will be penalized.  The "best" practices will not be required to be valid nor will be required to actually improve the outcomes of patients. Compliance with them may have actually been shown to directly hurt patients. Doctors will avoid high risk (sicker and more difficult patients) to ensure a good report card score. The Government will thus expand a program that has proven to harm patients and not proven to help anyone other than the government in cutting patient care costs. (Violates AMA Polices on Pay for Performance that require voluntary participation, valid data, proof of validity in pilot programs and a recent directive to the AMA leadership on "redistributed payments based on "quality" that are not valid)

The "Doctor buy a computer for the government and jeopardize patient privacy" act. Section 3002, page 656.  In the February "Stimulus bill" laws were passed to penalize doctors who did not buy and use computers for electronic medical records in ways approved by the government.  Incentive payments of $44,000 were offered for an estimated $120,000 worth of expenses and non-adopters faced a $42,500 penalty.  The current new act further penalizes doctors if they don't adopt electronic medical records to report patient medical information to the government. No guarantees are offered for patients privacy and no provisions made to compensate patients who are harmed by accidental disclosure of their medical data. (Violates AMA Policy on Pay for Performance requiring voluntary participation, adequate financial compensation for implementation of a government mandate and adequate compensation for EMR's as well as protection of patient privacy.)

The "Kiss the Feet of the Monarch Act"/deny constitutional right III: Section 3002, page 656.  Doctors shall NOT have access to administrative review or the courts to appeal unfair, inaccurate or adverse decisions of the Secretary or the Government regarding "appropriate" reporting of "quality" and "efficiency" data as determined by the Secretary.  However, Congress has seen fit to deem an "informal appeals process" of those professionals deemed "eligible" by the Secretary on whether their submission of data was "satisfactory" to the Secretary/Monarch. (Violates  AMA Policy H-340.971 "Medicare Program Due Process")

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David McKalip, M.D., Neurological Surgeon

Individual Freedom - Hard to earn. Easy to lose.

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