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The Real ObamaCare Fraud

The ObamaCare CBO score was based on a fraud. Hidden in ObamaCare is a more pernicious fraud: "bending the cost curve" by covert rationing.

Paul Hsieh


March 26, 2010 - 12:00 am
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Nor will this problem be confined to Medicare patients. As Betsy McCaughey notes, this will inevitably spill over onto patients with private insurance:

[ObamaCare] makes you enroll in a plan and then says that only doctors who do what the government dictates can be paid by your plan. “Qualified plans” can contract only with a doctor who “implements such mechanisms to improve health-care quality as the [current or future] secretary [of Health and Human Services] may by regulation require”(Sec. 1311, p. 148-49). That covers all of medicine, from heart care to child birth, stents to mammograms.

So if the federal government decides to “bend the cost curve” by requiring private insurers to adopt similar “bundled payment” schemes (as has already been proposed at the state level in Massachusetts), then this could affect all Americans.

Unlike the proposed 21% Medicare cuts, these long-term government “fixes” won’t explicitly force doctors to work at a loss. Instead, they will force doctors to choose between practicing according to their best conscience (and thus losing money for their “accountable care organizations”) or cutting medical corners to stay in the black.

These government-mandated “quality” and “cost effectiveness” measures will thus place doctors in a position where they are punished for upholding their Hippocratic Oath to treat patients according to their best ability and rewarded for violating it. If your doctor hears a suspicious heart murmur on a routine physical exam that warrants a cardiology referral, do you want him to hesitate — or even worse ignore it — because he fears being punished for sending too many patients to specialists?

Congress committed one fraud by failing to include the $247 billion “doctor fix” in its ObamaCare budget estimates. Congress committed another fraud when it passed a plan that it claimed would promote “quality” and “cost effectiveness” but will instead restrict and ration medical care for hundreds of millions of Americans.

Twenty years from now, which will we call the greater fraud?

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Paul Hsieh, MD, is a member of the Colorado chapter of Docs4PatientCare ( and co-founder of Freedom and Individual Rights in Medicine (
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