Posted on 02/20/2010 3:57:06 AM PST by hocndoc
When Congress returns from the Presidents Day recess next week, lawmakers will have just seven days to pass a bill to prevent a 21% cut in Medicare reimbursement.
Racing the clock to prevent cuts dictated by the sustainable growth rate (SGR) is nothing new. Every year over most of the past decade, Congress has voted at the eleventh hour to push planned cuts off for a year.
"Congress has a clearly established pattern to wait until the last minute to do a temporary patch," Cecil Wilson, MD, an internist in Winter Park, Fla., and president-elect of the American Medical Association (AMA) told MedPage Today.
Bob Doherty, executive vice president of governmental affairs for the American College of Physicians (ACP), said it's unlikely doctors would actually be subjected to the planned cut come March 1. What's not clear, he said, is what form the legislation will take -- if it will be a standalone bill or rolled into another bill being considered by Congress next week.
"'We don't know' is the honest answer," Doherty said during a Wednesday press conference unveiling a report addressing the "declining state of American healthcare" and the need for healthcare reform.
"What we are hearing is that one way or the other, somehow, something will stop the cuts from being enacted," he said.
Two high-ranking senators -- Max Baucus of Montana, and Charles Grassley of Iowa -- were set last week to include a seven-month reprieve from the cuts in a jobs bill, but Senate Majority Leader Harry Reid instead introduced a scaled-down bill that did not contain the SGR temporary fix.
"We will work to get a bipartisan agreement as soon as possible," Regan Lachapelle, a spokesperson for Sen. Reid, told MedPage Today.
While physician groups are expecting Congress to come up with some short-term fix next week, they are growing increasingly tired of the temporary patches and are pushing hard for a permanent repeal to the way physicians are reimbursed under Medicare.
"I hope we can stop this game of legislative chicken," said Wilson. "Seniors and physicians need to put pressure on their senators to support a comprehensive fix."
"We cannot support another temporary patch," said Joseph Stubbs, MD, an internist in Albany, Ga., and president of the ACP.
The House has passed a permanent repeal to the SGR, but the Senate has not.
While the ACP is intensely focused on the SGR issue this week and next, the group is not taking a break in its push for the passage of healthcare reform, said Doherty.
However, "the year-long reform effort remains stalled with no clear path forward," he said. Healthcare legislation stalled following the recent election of Massachusetts Republican Scott Brown to Ted Kennedy's old Senate seat.
Some lawmakers now seem to favor abandoning the sweeping healthcare bills passed by the House and the Senate in favor of smaller, narrower bills, coming up with a new broad bill, or using a legislative tool called reconciliation, which doesn't require 60 votes to meld the current bills.
Doherty wrote off these alternatives. Smaller bills will fail to have a large impact on the healthcare system, and the opposing party in Congress always wants to start over, he said.
As for passing a bill through reconciliation -- the procedure is reserved for budget bills, so any portion of the healthcare reform bill that does not reduce or raise revenue or relate to an entitlement program would stripped out. That would likely include insurance purchasing pools and the health insurance exchange, said Doherty.
The president is hosting a bipartisan meeting on Feb. 25, and Doherty and Stubbs hope the event will recharge the healthcare reform movement.
Doherty said he remains hopeful, considering this is the closest that Congress has ever come to passing healthcare reform. During the failed efforts of the 1990s, neither chamber ever passed a comprehensive bill, he pointed out.
Close isn't good enough, Stubbs said. Or, in his southern parlance, "close only counts in horseshoes." He said he remains "Pollyanna-ish" about the likelihood of reform passing.
But if, after the meeting the president has scheduled on reform next week, Congress is still unable to pass healthcare reform, the odds of it passing at any time during Obama's presidency are not good, Doherty predicted.
I've been prediciting that doctors will be drafted into government service when enough of us get tired of trying to deal with (and send our kids to college on) payment from Medicare. The time may be here.
More information from the American Academy of Family Physicians http://www.aafp.org/online/en/home/publications/news/news-now/government-medicine/20100217spkout-pay-cut.html
Medscape.com http://www.medscape.com/viewarticle/716946
I thought you’d like to see the good news, humble!
This will be the fastest resolution of a problem in U.S. history.
The government is the customer. That is what we have now.
We have the government owning 2/3rds of the auto industry. They own 80% of AIG. They control, can let fail or bail out any bank.
They control 95% of all education.
Near half the population is either on welfare, or accepts government monthly checks for survival.
Nice, eh?
Please. Doctors need cash flow. No work-ee, no pay-ee. Who
s going to make the office, equipment, insurance tax payments? Who’s going to pay to keep the staff? What about personal expenses, house, car, kid’s school?
What about lawsuits, and of course patients with dire needs?
Like the rest of us, Doctors are chained, tied, ruled, regulated to the blob.
We could work for cash only. Refuse to bill any insurance, Medicare or Medicaid. Cash only. That would keep enough money coming in to keep the doors open, and still make the point.
Of course as an ER Doc I would have to decide if I was going to show up to work and be buried or find another line of work as we are barred by law from even about payment before we do our “screening and stabilizing”.....
Saaaayyyyyy... the MDA endorsed this pig of a muzzie in chief... weird huh!
LLS
Remember the Sea of White at the WH?
The White Coat Brigade ordered by our CIC to put on those white coats, shut up, sit down and clap?
Weird...
I could well see a reverse Reagan air traffic controller act. Work or hand in license. Obama told bond holders for GM to take a hike. Basically, took their property, stole it for zero. FDR ordered all American to turn in their gold, for paper script.
Lincoln, Wilson, FDR all jailed with out trial, 20-30,000, or more American citizens.
What I am getting at is don’t think that push comes to shove vis a vis the government that a minority is protected.
Anyways, what you are saying is already happening. Physicians are going Galt. Retiring, not entering the field, not taking Medicare/caid. Working for cash. This is perfectly natural. Nothing get’s done with out rewards. No rewards, no work.
Being a physician, I imagine, still has it’s not monetary rewards. Purpose, usefulness, prestige, interesting work.
In the end I just see the government as a high cost,low quality, slow innovator of goods and services. The more it intervenes, the worse things get, the more it feels it has to intervene.
Look at the affordable air line prices, and every street bum and his brother with his texting, multi media phone. All the result of deregulation. That is freeing the producers and customers to hash it out amongst themselves.
This is what is needed in medicine. Government, government payment needs to get out. Innovation, economy, consolidation, price drop and expanding the customer base. Let the industry and customers jostle in a million ways amongst themselves.
Very weird.
LLS
Won’t happen....the docs will sign on to “ObamaCare”...and be rewarded....via...
http://www.freerepublic.com/focus/f-news/2454137/posts
And, since “HIPPA,” or the Social Security Act of 1997, there has been no true physician-patient privilege.
That Act allowed Medicare inspectors and anyone claiming to work for the Secreatary of Health and Human Services (a whole cascade down to the Medicaid and local health services) to write their own subpoenas, to come in to the office and not only see everything in the office (one woman doctor was arrested for refusing to open a drawer in her desk), but to make video recordings and copies of records.
Most doctors kept working for free last summer when there was no money because the budget hadn’t passed - because Medicare promised us that the payments would be retroactive. Most kept working in September, when the government suspends pay for a couple of weeks to shove some costs over to the next fiscal year.
I resigned from the AMA at the first of the year. I know of several large groups and more individual docs who did the same. The AMA doesn’t seem to have noticed. They still duns me as though I owe them, even got a phone call on my cell last week.
The Texas Medical Society, on the other hand, has never approved of “reform” and has fought steadfastly for tort reform and payment reform.
I wasn’t aware of that, and in my opinion, it is unconstitutional.
My first post on FR was about the Act, back in August,1998, I think.
Amazing thread - and thank you both for your comments on it.
Prayer is the answer here - really and truly. Will add the medical field to prayer list.
Sorry for not doing so sooner!!!
I dislike the government taking over aspects of healthcare
simply because the government has been proven inept.
But the argument that such a takeover would result in a
bureaucrat dictating heathcare is not necessarily what it seems.
Folks don't get to decide that NOW for themselves.
I don't get to decide what treatment I get. Some title-wielding
"doctor" does. Who stands to profit thereby. How will a
government agent change anything at the treatment level?
It's STILL not MY decision.
There is a "doctor" who decides. This "doctor" stands
to gain financially from any decisions. The person involved
does NOT have a say in any treatment, other than "no".
Do I want a disinterested pencil-pusher or a greedy
arrogant title-user deciding what I need? Not thrilled about either.
I'd probably tend toward the fellow without the fake royalty title.
I'd still call him a liar when he claims his name is "doctor" though.
Sorry it took so long to respond.
Unfortunately, if the government takes over, you’ll have the pencil pushers forcing the docs to be their agents in deciding how best to manage “limited resources.” And they’ll limit them as best as they can.
But you fail to address the issue of "care will be out of our hands and into the government's".
It isn't in our hands now. What's the difference?
Oh, are you mandated to buy health care insurance, now?
If and when you become Medicare eligible, you will be forced to join Medicare at penalty of higher costs if you join later and at worry of not being able to find a doctor brave enough to risk the Office of Inspector General.
I hear they have chiropractors in every town and there’s naturopaths in some parts of the country. You’re also welcome to buy your own blood pressure cuff and talk to the lady down at the General Nutrition Center. The Pharmacist has his/her own title.
Or, if you explain your theory about phony titles well enough and often enough, I’ll bet your doc will allow you to choose all your own meds, from now on. Or, you could spend a few years studying up on your own, HG.
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