The Link Blog of Jeff Berg

The Medicare denial rate found in the study was, on a weighted average basis, roughly 1.7 times that of all of the private carriers combined (99,025 divided by 2,447,216 is 4.05%; 6.85% divided by 4.05% =1.69).

You would think Medicare’s sheer size might enable it to have smoother procedures with its providers that would enable it to turn down a lower percentage of claims. But no, this is the government we’re talking about.

So who’s the most “heartless” now? And why should Americans accept the idea of gradually being forced into a government-run system when, based on documented government experience, they will be more likely to see their claims denied?

“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.”

Translated into plain English, it means that in any year in which a particular doctor’s average per-patient Medicare costs are in the top 10 percent in the nation, the feds will cut the doctor’s payments by 5 percent. Forget results. This provision makes no account for the results of care, its quality or even its efficiency. It just says that if a doctor authorizes expensive care, no matter how successfully, the government will punish him by scrimping on what already is a low reimbursement rate for treating Medicare patients. The incentive, therefore, is for the doctor always to provide less care for his patients for fear of having his payments docked. And because no doctor will know who falls in the top 10 percent until year’s end, or what total average costs will break the 10 percent threshold, the pressure will be intense to withhold care, and withhold care again, and then withhold it some more. Or at least to prescribe cheaper care, no matter how much less effective, in order to avoid the penalties.

The Obama administration has privately concluded that a cap and trade law would cost American taxpayers up to $200 billion a year, the equivalent of hiking personal income taxes by about 15 percent.

A previously unreleased analysis prepared by the U.S. Department of Treasury says the total in new taxes would be between $100 billion to $200 billion a year. At the upper end of the administration’s estimate, the cost per American household would be an extra $1,761 a year.