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It's Starting: Calif. Obamacare To Cut Hospitals That Perform 'Too Many' Surgeries

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If you like your doctor, you can keep your doctor.

If you like your health plan, you can keep your health plan.

If you like the surgery you’re about to receive, you can get the surgery you’re about to receive.

Yes, that’s the latest cost-cutting measure that’s about to hit Obamacare recipients. In California, according to the American Spectator, they’re going to start cutting funds to hospitals that perform too many surgeries. How many is too many, of course, is whatever the nearest bureaucrat says that it is.

“Covered California, the state’s health insurance marketplace under the Affordable Care Act, has devised what could be a powerful new way to hold hospitals accountable for the quality of their care,” WBUR-FM noted approvingly.

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“Starting in less than two years, if the hospitals haven’t met certain designated targets for safety and quality, they’ll risk being excluded from the ‘in-network’ designation of health plans sold on the state’s insurance exchange.”

Ah yes. Arbitrary numbers are there for “safety and quality.” For instance, do you know that anything more than 23.9 percent of C-sections for “low-risk” births is an affront to “safety and quality?” Not 24.0, mind you. If you do 24.0 percent of C-sections for “low-risk” births, you’re simply not rationing care enou… err, I mean, not adhering to standards.

“We’re saying ‘time’s up,'” Dr. Lance Lang, chief medical officer for Covered California, told WBUR.

“We’ve told health plans that by the end of 2019, we want networks to only include hospitals that have achieved that target.”

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C-sections have come under particular scrutiny; “Even for low-risk cases, Lang says, several California hospitals are delivering 40 percent of babies by C-section. At one hospital, it’s 78 percent,” WBUR reported, noting that hospitals get reimbursed more for C-sections than normal deliveries.

“That means that when a woman goes to a hospital, it’s the culture of the hospital that really determines whether or not she gets a cesarean section, not so much her own health,” Lang said.

That sounds nice until you realize the dangerous precedent it sets — not just with C-sections, but with other surgeries.

Take, for instance, the fact that “state data show there are about 40 hospitals that are still far off the target in California, including a cluster of hospitals in East Los Angeles that treat low-income, often uninsured, patients.”

“If you have somebody who is on methamphetamines and is homeless and has not gotten any prenatal care, her chance of a C-section is way higher than someone who is not all those things,” Dr. Malini Nijagal, an OB-GYN at Zuckerberg San Francisco General Hospital, and the University of California, San Francisco, told the NPR station.

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“And so the problem is, how do you adjust for the patient population of a hospital?”

That is a pretty major problem, particularly when you can bet this won’t end with C-sections, either. Massive federal and state bureaucracies will start setting targets and if your hospital doesn’t meet the target, well, that’s not going to be good for you.

It’s also going to force doctors to make decisions for their patients they wouldn’t ordinarily make. Instead of improving quality, this puts quality at the mercy of statistics in the belief that statistics know better than doctors. And if you think rationing is just going to be confined to California, you’re dead wrong — at least, as long as Obamacare continues to be the law of the land.

Let’s remember that the GOP controls both houses of Congress and the White House. It’s time they put doctors back in control of what kind of care Americans get.

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C. Douglas Golden is a writer who splits his time between the United States and Southeast Asia. Specializing in political commentary and world affairs, he's written for Conservative Tribune and The Western Journal since 2014.
C. Douglas Golden is a writer who splits his time between the United States and Southeast Asia. Specializing in political commentary and world affairs, he's written for Conservative Tribune and The Western Journal since 2014. Aside from politics, he enjoys spending time with his wife, literature (especially British comic novels and modern Japanese lit), indie rock, coffee, Formula One and football (of both American and world varieties).
Birthplace
Morristown, New Jersey
Education
Catholic University of America
Languages Spoken
English, Spanish
Topics of Expertise
American Politics, World Politics, Culture




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