Negotiation … or Coercion?
The new congress wants to “negotiate” with drug companies for Medicare Part D. Common sense, right? It all depends on how you define negotiate.
I’m all in favor of the government negotiating for the the best price. Unfortunately, that’s not what the government does in the case of Medicare. A prime example is how Medicare sets physician reimbursement rates.
Let’s assume that you are an internist. Every year the government publishes a schedule of how much you will get paid for each procedure you bill. Depending on what part of the country you’re in you get paid a little more, or a little less. It’s a matter of public record. The government didn’t negotiate with the doctor, they simply told you how much you will get paid. Personally, I don’t have a problem with that. If you don’t want to treat Medicare patients at the going rate, then simply let your patients know in advance that you will be charging a higher rate and if they want to continue using your services they will have to pony up.
Wait. You can’t do that. If you treat an individual with a Medicare card you will have to accept the the amount allowed by the Feds. If you charge them one penny extra, you are now a criminal. In all fairness, Medicare allows doctors to “not participate”. The rules are a little tricky, but trust me when I tell you that it’s more economically efficient to either participate with Medicare (and receive benefits such as automatic billing of the patients Medigap policy) or simply refuse to treat anyone over the age of 65.
Now, go to the flip side. You are the patient. You are on Medicare. You have a net worth of millions of dollars. You want the best treatment that money can buy. You tell your doctor that you are willing to pay extra for certain treatments. Sorry, that’s illegal too. Your doctor may be your best friend, but he’s not going to jail for you. In the real world, these things do happen. People make contributions to hospitals. They make donations to doctors’ favorite charities and make sure that the doctor receives recognition. The list goes on. Some physicians may even take a little cash under the table. But the bottom line is that the market is not permitted to work.
Liberals will claim that this is the way it has to be. Old people will be taken advantage of by unscrupulous doctors. They system will go bankrupt. I’ve got news for you. The system is already bankrupt! Thanks to our great President, it’s going bankrupt at an accelerating rate. Twenty years from now, when we all are part of a single-payer healthcare system (known in the real world as socialized medicine), it won’t be Hillary Clinton that gets the blame (or credit), it will be George W. Bush. Medicare Part D has all but assured us of a future of socialized medicine. If we don’t go to a single payer plan, Medicare will simply blow up in the government’s face. They will have to put younger people into the plan (of course they’ll give it a “younger” name) in order to keep Medicare afloat. Of course that will happen; not because of some “moral responsibility” to our seniors, but because seniors VOTE.
This brings us back to the “negotiation” with drug companies. Since the only system the folks running Medicare are familiar with is one where they dictate the price and then refuse to allow the private party to pay or charge more we can only assume that we will have effective price controls on drugs. If you honestly don’t understand that the market works, stop reading here. Otherwise, common sense dictates that innovation in pharma will grind to a halt under this system. Forget a cure for AIDS, or new antibiotics which will keep us alive because bacteria continue to mutate and become resistant to the drugs we presently have.
At the end of the day, coercion is wrong. If you believe in liberty, you must believe in economic freedom. Unfortunately that won’t happen with healthcare in the US, thanks to George W. Bush and his new friends in the Democratic Congress.
Technorati Tags: healthcare, Medicare, MedicarePartD, drugs, BigPharma, coercion, liberty, economics, socializedmedicine
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