Fix Health Care Policy

Time to Clean Up the Medicare Doctor Payment Mess

Congressional Quarterly is reporting that the United States Senate is going to enact a one-month reprieve for Medicare physicians, saving them once again from a draconian reduction in Medicare payment.

This entire system is a mess. Under the existing Medicare payment formula (the Sustainable Growth Rate, or SGR) for doctors that the Senate and their House colleagues enacted in 1997, physician reimbursement is tied to the performance of the general economy. If in any given year Medicare physician payment outpaces the growth in the general economy, there is an automatic proportional reduction.

Routinely, Congress has blocked the annual payment reductions, but then, under the congressional formula, the payment reductions accumulate. Yet another flaw of the Patient Protection and Affordable Care Act is that it did not fix the physician payment problem. The result: This December, Medicare doctors will face a 23 percent cut in pay. A one-month extension of the reprieve would guarantee that the cuts next month would be even greater, requiring another congressional intervention. (more…)

Tags: Medicare "doc fix", ObamaCare, Patient Protection and Affordable Care Act, physician payments, Sustainable Growth Rate

States Fighting Back Against Obamacare: Virginia

Although President Obama signed the Patient Protection and Affordable Care Act into law , the battle against the federal takeover of health care is far from over. To the contrary, states continue to fight against the vast overreach of Washington marked by the passage of the Patient Protection and Affordable Care Act, which impedes states’ abilities to enact their own health care reform or continue existing programs.

One of the first to arrive on the battlefield against the President’s health bill was Virginia Attorney General Ken Cuccinelli. As we highlighted last week, constitutionality is at the heart of Cuccinelli’s battle against Obamacare’s individual mandate, which requires all Americans to purchase a level of health insurance deemed acceptable by the federal government, or else pay a penalty. But in March, Virginia passed its own statute protecting Virginians from having to comply with such a mandate, which serves as the backbone to Cuccinelli’s case against Washington. (more…)

Tags: federal takeover health care, Patient Protection and Affordable Care Act, Virginia, Virginia Attorney General Ken Cuccinelli

Congressional Gimmicks leave Doctors and Taxpayers in a Lurch

The Senate voted 45-52 yesterday to oppose the $140 billion so-called “extenders bill” (HR 4213). The Hill is reporting that Sen. Max Baucus (D-MT) is going to offer a slimmed down version for consideration as early as today. Two key health provisions of the bill are expected to be a continued bailout of state Medicaid programs and a temporary Medicare ‘Doc Fix’.

The Sustainable Growth Rate (SGR), initiated in 1997, links the increase in Medicare reimbursement rates to growth in GDP. Since medical costs historically increase at a rate more than twice GDP, the SGR reduces the real payments physicians receive. A temporary “fix” has happened nine times in nine years to increase Medicare rates above SGR levels. Temporary fixes are the easy way out for politicians because they appear less costly to budget.

The Hill reports that Senator Baucus is going to use a budgetary trick by paring down the “doc fix” from 19 months to 6 months. Of course, this means that the budgetary cost of the bill will appear smaller, but in reality the only difference is that Congress will have to revisit this issue in 6 months instead of 19 months – kicking the can down the road once again. (more…)

Tags: doc fix, federal spending, Medicare, Patient Protection and Affordable Care Act, Sustainable Growth Rate, tax extenders bill

In Medical Malpractice Reform, States Should Shirk the Washington Way

It’s long been established that part of controlling rising health care spending in the United States will mean enacting meaningful medical malpractice, or “tort”, reform. Though tort reform is not a silver bullet to creating savings, it is one of many changes vital to containing patients’ medical costs.

Unfortunately, in passing the mammoth Obamacare, Congress and the president failed to take tort reform seriously, leaving out any serious provisions to encourage states to reform their medical malpractice laws. Instead, the Patient Protection and Affordable Care Act threw an illusory bone to Republicans, the main proponents of tort reform, through the inclusion of $25 million in demonstration grants to try out new state-level ideas for reform.

This week, the Department of Health and Human Services announced the winners of the grants. The money will be split among small, voluntary programs by hospitals and medical centers and “planning grants”. Completely unacknowledged are the several states where malpractice reform has already been enacted with clear results. (more…)

Tags: medical malpractice reform, ObamaCare, Patient Protection and Affordable Care Act, planning grants