Stimulus Bill Raises Concerns Over Government Rationing of Health Care

Two provisions in President Barack Obama’s economic stimulus plan could give the federal government the authority to oversee the medical decisions made between doctors and patients, critics warn, which could result in the rationing of health care.

The plan to make all health records electronic and establish an effectiveness board to review health care costs was part of the $838 billion economic stimulus bill that passed the Senate Tuesday

The bill provides $3 billion to computerize health records, a measure intended to cut costs and reduce medical errors. Language in the stimulus bill calls for “the utilization of an electronic health record (EHR) for each person in the United States by 2014.”

This will require the establishment of the office of National Coordinator for Health Information Technology. The new office ‘‘provides appropriate information to help guide medical decisions at the time and place of care,” according to the language in the bill.

Further, the legislation also spends $1.1 billion to establish a Federal Coordinating Council for Comparative Effectiveness Research, which would serve as an umbrella group for all federal health programs, including Medicare, Medicaid, S-CHIP, and veterans’ care, with 15 members from various federal agencies making determinations about health care needs and cost-effective treatments

According to the bill, the secretary of Health and Human Services “shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use” by health care providers.

The bill also indicates that a doctor who is not a “meaningful EHR user” in terms of using patients’ health records to provide the most cost-efficient coverage could face penalties.

President Obama, during his press conference Monday, touted the goal of modernizing the health care system, which he said would save billions of dollars and save lives

“We know that health care is crippling businesses and making us less competitive, as well as breaking the banks of families all across America — and part of the reason is we’ve got the most inefficient health care system imaginable,” Obama told reporters. “We’re still using paper. We’re still filing things in triplicate. Nurses can’t read the prescriptions that doctors have written out. Why wouldn’t we want to put that on an electronic medical record that will reduce error rates, reduce our long-term cost of health care, and create jobs right now?”

One problem critics note is that the electronic medical records will be mandatory.

“I am not against electronic records,” Betsy McCaughey, former lieutenant governor of New York, told CNSNews.com. “I am against coercing doctors to limit care. I certainly do not support vague guidelines. E-records are fine as long as they are not mandatory.”

McCaughey, an adjunct senior fellow at the conservative Hudson Institute, told CNSNews.com there is “no question” that the goal is to ration health care to control costs. That is achieved, she said, by first putting every individual in a medical treatment database, and secondly by putting the new effectiveness council in charge of providing doctors with guidelines for how to most effectively treat those patients based on the data.

“We plan to work closely with members of the House-Senate conference committee to craft a final bill that improves health care coverage, promotes widespread adoption of HIT (health information technology) that will work in physicians’ offices, and promotes independent clinical effectiveness research,” said Dr. Joseph Heyman, chairman of the AMA board.

While rationing is the likely goal of the Obama administration, these goals of an effectiveness task force likely will not make it through Congress, said Michael Cannon, director of health policy studies at the libertarian Cato Institute.

“It’s ironic that advocates of free market health care believe there is too much waste in government programs. The concern of the left is that this won’t lead to rationing,” Cannon told CNSNews.com. “Congress has been down this road before. There have been studies identifying low-value medical care. But the people providing low-value medical care are influencing Congress. There is no sense for either the left or the right to spend taxpayer money on this.”

A Cato study released last week blamed the government for high health care expenses. “Federal tax and entitlement policies, as well as state licensing of health insurance and medical professionals, inhibit the types of health plans best equipped to generate comparative-effectiveness information,” the study claimed.

“A better way to generate comparative-effectiveness information would be for Congress to eliminate government activities that suppress private production,” the Cato study said. “Congress should let workers and Medicare enrollees control the money that purchases their health insurance. Further, Congress should require states to recognize other states’ licenses for medical professionals and insurance products.”

Though the bill, still under final revision in Congress, states that privacy of electronic health records will be protected, Sue Blevin, president of the Institute for Health Freedom, is concerned that there is not an opt-out for people who choose not to have their records computerized and entered into the national network.

“Without those protections, Americans’ electronic health records could be shared – without their consent – with over 600,000 covered entities through the forthcoming nationally linked electronic health records network,” Blevin said in a statement.

“Unless people have the right to decide if and when their health information is shared or whether to participate in research studies, they don’t have a true right to privacy.”

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