The Bipartisan “Doctor Fix”
Last week, Senate Republicans cowered and caved in to yet another short-term Medicare “doc fix” that kicks the can down the road until the end of November. Without the so-called “doc fix,” Medicare reimbursements to physicians would have suffered a catastrophic reduction of 21 percent as of June 1, as I wrote in an earlier post.
Last Friday’s unanimous Senate vote in favor of “fixing” the fee-schedule for another few months was followed Thursday evening by a 417-1 vote (with 14 not voting) in the House of Representatives. (The lone opposing vote was cast by the very liberal Democrat George Miller.)
What do Republicans think they have achieved by pretending that they have “fixed” the fee-schedule? As my previous post and Dr. Goodman’s recent post show, doctors are leaving Medicare in droves even with these short-term fixes! So, by continuing to share “joint-ownership” of unreformed Medicare with Democrats, Republicans lose (once again) an opportunity to differentiate themselves on health reform between now and November.
Perhaps it was necessary for the Republican Senate leadership to carve the “doc fix” out of the horrible “jobs bill” to ensure that the same Republican Senators who voted for the previous “jobs” bill in February did not vote for this month’s budget-buster. Fair enough, but when Senator Reid gave up on the bigger bill Thursday evening, and Speaker Pelosi brought the “doc fix” to the House floor, the House Republicans could at least have not voted on the darned thing.
If Republicans had proposed to junk the entire Medicare fee-schedule, and replace it with a voucher that would allow patients and physicians to figure out how much each medical service is worth, they would have had four months to market this idea to voters who are quickly learning that Medicare beneficiaries are already facing increasingly limited access to care.
This is not an easy political lift, to be sure. But if they can’t even do this for Medicare, how the heck are they going to repeal ObamaCare and replace it with a tax credit?
Question: Why don’t the doctors clean house: fire the current leadership of the AMA and replace them with leaders who represent doctors for a change.
John, the answer to your question about Republicans is that they are not much better than the Democrats. They never have been.
There is a huge difference in what the basic tenants are for Reps and Dems. The similarity lies in that their job is to be in government– they have ‘nothing’ else, so they do what they think is right for their career. It is merely what they perceive as self preservation, instead of right for the governed
One thing for sure, this process perpetuates the role and the importance of government in the health care system. Maybe the Democrats are trying to maximize their political donations from doctors. For that matter, maybe Republicans are too.
As a student Nurse Practitioner, I find the current political climate rather disturbing. The partisan politics with neither side agreeing to ANYTHING will continue to delay the inevitable. Medicare is fast becoming bankrupt and our elderly population continues to grow. Meanwhile, the senior citizens have to decide between groceries and needed medications. I cannot begin to count the number of times I have seen my patients “ration” their medicine and diabetic supplies in order to stretch dollars. Is the new health reform bill going to help? With the amendments and other changes being added to the reform package, that is likely anyone’s guess.
The Sustainable Growth Rate (SGR) formula is designed to tightly control the growth in Medicare spending by creating a pot of money that grows at a fixed rate, which is used to compensate all Medicare providers. The SGR formula is essentially trying to rein in spending using a community tax on the “commons” when doctors collectively exceed the designated growth rate. Collective punishment for individual action is never effective.