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Doctors as Indentured Servants? Aynrandcenter.org

Tuesday, April 27, 2010



From the Ayn Rand Center
 

Massachusetts law would turn doctors into serfs

April 27, 2010 by Don Watkins

Throughout the health care debate, we have been arguing that the push for government control of health care is driven by a certain moral view: the view that need is a claim. That view is typically taken to be noble and benevolent, and one of Ayn Rand’s most controversial conclusions is that it is in fact vicious and unjust. Well, the latest proposal out of Massachusetts seems designed to prove Rand’s point.

Massachusetts, you probably know, passed a bill very similar to ObamaCare a few years back. Well, shocking news: the state is now hemorrhaging money. To stop the bleeding, it is clamping down on doctor reimbursements for Medicare and Medicaid, which has meant fewer and fewer doctors willing to accept Medicare/Medicaid patients. The state’s solution? Force them.

Every health care provider licensed in the commonwealth which provides covered services to a person covered under “Affordable Health Plans” must provide such service to any such person, as a condition of their licensure, and must accept payment at the lowest of the statutory reimbursement rate…

As one doctor noted:

So what this means is that in order for doctors to become licensed in Massachusetts, they will have to agree to accepting the payment rates imposed by the government, even though those payments may not cover their actual expenses for the care rendered.

Unbelievable.

But it isn’t unbelievable–not if you view need as an entitlement. If a Medicare patient’s need of health care entitles him to it, then why should a doctor have the right to refuse service just because the doctor won’t make money? Wouldn’t that be selfish and greedy?  

There is nothing noble or benevolent about political thugs forcing doctors–the men and women without whom all of our health care needs would go unfulfilled–to sacrifice their time, their energy, and their wealth to anyone’s need.

Remember: the morality of need means serfdom for doctors

Here's the bill:

SENATE DOCKET, NO. 2188 FILED ON: 7/23/2009

http://www.mass.gov/legis/bills/senate/186/st02pdf/st02170.pdf
SENATE . . . . . . . . . . . . . . No. 2170
The Commonwealth of Massachusetts
_______________
PRESENTED BY:
Richard T. Moore
_______________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled:
The undersigned legislators and/or citizens respectfully petition for the passage of the accompanying bill:
An Act Relative to an Affordable Health Plan.
_______________
PETITION OF:
NAME:
DISTRICT/ADDRESS:
Richard T. Moore
Worcester and Norfolk
Michael O. Moore
Second Worcester
Stephen M. Brewer
Worcester, Hampden, Hampshire and Franklin
Susan C. Tucker
Second Essex and Middlesex
The Commonwealth of Massachusetts
_______________
In the Year Two Thousand and Nine
_______________
An Act Relative to an Affordable Health Plan.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:


SECTION 1. "Statutory Reimbursement rate" means, with respect to payment to a health care

1 provider for services rendered to any person covered under an "Affordable Health Plan", one hundred and

2 ten percent of the Medicare reimbursement rate for those services as if there were rendered to a Medicare

3 beneficiary not taking into consideration any beneficiary cost sharing. For services or supplies for which

4 there is no Medicare reimbursement amount, the amount as determined by the Division of Health Care

5 Finance and Policy to be consistent with Medicare payment polices at a one hundred and ten percent level

6 and approved by the Commissioner of Insurance.

7 (a) As a condition of doing business in the commonwealth, a carrier that offers health benefit plans to

8 eligible small businesses and eligible individuals, as defined by chapter one hundred and seventy-six J,

9 shall offer an "Affordable Health Plan" to all eligible individuals and small businesses, both within the

10 Connector, for such carriers participating in the Connector, and for all such carriers outside the

11 Connector. This "Affordable Health Plan" shall contain benefits that are actuarially equivalent to the

12 lowest level benefit plan available to the general public within the Connector, other than the young adult

13 plan. Payment for all services, other than outpatient pharmacy benefits, for all providers under

14 "Affordable Health Plans" shall be consistent with the requirements as included in paragraph (b).

15 (b) Claims for services shall be adjudicated at the in-network benefit level or, if applicable under the

16 terms of the plan, the out-of-network benefit level based on the participation status of the provider in the

17 carrier’s network. Every health care provider licensed in the commonwealth which provides covered

18 services to a person covered under "Affordable Health Plans" must provide such service to any such

19 person, as a condition of their licensure, and must accept payment at the lowest of the statutory

20 reimbursement rate, an amount equal to the actuarial equivalent of the statutory reimbursement rate, or

21 the applicable contract rate with the carrier for the carrier’s product offering with the lowest level benefit

22 plan available to the general public within the Connector, other than the young adult plan, and may not

23 balance bill such person for any amount in excess of the amount paid by the carrier pursuant to this

24 section, other than applicable co-payments, co-insurance and deductibles.

25 (c)Providers shall not attempt to recoup such excess amounts by increasing charges to other health benefit

26 plans or other payers. The Division of Health Care Finance and Policy shall monitor provider charges to

27 ensure compliance with this section and report any non-compliance to the Attorney General. The

28 Division of Health Care Finance and Policy shall promulgate regulations enforcing this subsection, which

29 shall include penalties for noncompliance.

30 (d)Existing contracts between providers and carriers shall comply with the requirements of this Section as

31 to the reimbursement rate and providers must provide services to individuals under "Affordable Health

32 Plans" under such existing contracts with carriers. A provider that participates in a carrier’s network or

33 any health benefit plan may not refuse to participate in the carrier’s network with respect to the

34 “Affordable Health Plan”.

35 SECTION 2. Section 1 of this act shall be repealed upon such date determined by the

36 Commissioner that a common payment methodology has been implemented across all public and private

37 payers across the commonwealth.

 
  
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