Barack Obama Has the Last Word on the Medicare “Doc Fix”
I thought that I had given the last word on the flawed Medicare “doc fix” last Monday. Nope: That honor goes to President Obama. During the three week period the secretly negotiated “doc fix” legislation was being rushed through Congress (“rushed” because the Senate was in recess for most of it), I wrote an article suggesting Republicans who voted for it might be casting their first vote for Obamacare. Well, don’t take my word for it. Now that he’s signed the bill, President Obama has hosted a fabulous garden party for the politicians who voted for it. Yahoo has the whole story, including a photo of Speaker Boehner planting a bipartisan kiss on the cheek of Minority Leader Pelosi. One of my charges was that the law increased federal control of the practice of medicine.
Here’s what the President had to say about that:
“I shouldn’t say this with John Boehner here, but that’s one way that this legislation builds on the Affordable Care Act,” Obama said, adding, “But let’s put that aside for a second.”
“Speaker Boehner planting a bipartisan kiss on the cheek of Minority Leader Pelosi.”
Yikes. This will make any attempt at repealing or revamping the ACA a lost cause.
I suppose one of the reasons for the apparent support by so many medical societies was the fear that many would drop out of medicare if the SGR were not abolished.When physicians face the degree of control and absurdity that rolls out with the second phase of MACRA I suggest many more docs will no longer see medicare patients.It is mind boggling that so many medical societies are claiming a victory when in fact it is a staggering loss for the physician patient relationship and for real evidence based medicine.
It does not appear the medical societies are working for the docs does it?
Well, I am not a doctor, so I cannot confirm that. However, there is always a question of “agency”: Are the society’s leaders effective agents of the members? “Agency theory” is a fascinating area of economics, and concludes that it can be very difficult for principals to ensure agents are serving the principals’ interests.
The thing that free-market types like about specialty societies and board certification is that it is voluntary. As the societies move more towards being agents of the state (instead of their members), it obviously becomes less free market.