Intrusive, Unethical and Wrong

February 22, 2017

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First, a question: If YOU were king or queen, what’s the one thing you’d change in health care? At a town hall meeting, one woman answered: “Why can’t it just be simple?” What do YOU say? Send your answer to and I’ll share them in a coming eNews.
Now, let’s switch to an unpleasant reality. Your doctors are mostly working for outside taskmasters, not you. “He who pays the piper picks the tune,” it’s often said, and for many, that’s not the patient. So, let me introduce the taskmaster’s latest control tactic: “value-based purchasing.”
VBP is a takeover of the practice of medicine. It’s supported by Republicans and Democrats as a solution to rising costs…but it’s intrusive, unethical, and wrong. And it will lead to rationing of medical services.
I’ll make it simple. Doctors are paid for the “value” of their services – as defined by the government and insurers – not for the services actually provided. So, for example, rather than getting paid for time and expertise, surgeons get paid for patient outcomes, which can vary due to patient physiology, genetics and more. Here’s a typical formula for “value” from AMJM:
Imagine if a police officer was paid this way. Would he receive better pay for crime-free days, fewer truant students, and complaint-free shifts– even though he had nothing to do with it? The more crime, the less pay.
Likewise, “patient satisfaction” scores can lead to lower payments (thus, hospital lobbies look like fancy hotels and offer Starbucks). Pay can also be reduced for complications (even though the doctor’s not at fault), for patients that continue to smoke, for diabetics that have poorly maintained blood sugar levels, for readmissions and more.
Would your plumber or hairstylist or child care worker let you pay only for “value,” as defined by you? I think not. But the Medicare administration writes: “Payment is not directly triggered by service delivery so volume is not linked to payment. Clinicians and organizations are paid and responsible for the care of a beneficiary for a long period (e.g. ³ 1yr).”
Intrusion is coming. VBP changes the focus of medical practice. Hospitals and doctors are paid to keep you healthy all year long. They will “leverage demographic and lifestyle data to proactively identify additional risk attributes which may adversely affect a member’s current health state,” reports LexisNexis. One LexisNexis PowerPoint graphic shows the data sources to be used:
To counter big government controls and to bring patients and doctors back together in trusted, caring relationships for affordable treatment, CCHF launched The Wedge of Health Freedom ( There are only two choices: government tyranny or American freedom. You choose.
Choosing freedom,
Twila Brase
President and Co-founder