They're lives, not commodities

Tuesday, September 24, 2013

On July 1, CMS began Round 2 of competitive bidding in more than 90 metropolitan areas. The program cut reimbursement rates by 45% to contracted suppliers and has significantly reduced the number of local businesses allowed to serve Medicare patients. While CMS gloats at billions saved for the taxpayers and for beneficiaries, such dramatic cuts should lead us to question the integrity of the program. If only for a moment, let’s look beyond detached cost versus quality analyses to realize that our government is now auctioning off the health of our seniors. Is it fair to Medicare beneficiaries—or rather, is it moral—to sell their wellbeing to the lowest bidder?

“Competitive bidding” auctions by the federal government—and criticisms of them—are not new. In 1961, upon his return to earth as the first American to have orbited in space, astronaut Alan Shepard was asked by Walker Cronkite what his final thoughts and feelings were as he prepared to take off. One might think that he was filled with excitement about the feat he was about to achieve. However, in his response to Cronkite’s question, Mr. Shepard remarked that, “It’s a very sobering feeling to be up in space and realize that one’s safety factor was determined by the lowest bidder on a government contract.”

The sentiment expressed by Mr. Shepard is critical to the dialogue of reshaping our healthcare system. Yet neither those that support competitive bidding in Medicare nor those that berate it seem to consider ethical issues surrounding the program.

In our clash over the program, academics, government officials and industry representatives fixate so intently on numbers that we seem to have overlooked the issue of morality. Let’s move away from our detached analysis to discuss that we’re dealing with more than commodities—we’re dealing with lives. Right now, in almost 100 metropolitan areas, the old man you see on oxygen at the grocery store must trust his health to a company that bid the lowest to take care of him.

Yes, we, as a nation, are broke and in debt. But are we, with the highest GDP in the world, so poor that we have to bend our morals and auction Grandma’s health to make ends meet?

—Jeremy Keith Houghton, vice president of corporate strategy, United Oxygen Service, Inc.