The Senate passed the bill blocking a 10.6 percent Medicare payment cut today by a veto-proof margin of 69-30.
A hat tip to the Democrats who played this scenario balls-out. They took the initiative after the bill passed so decisively in the House. The Republicans were snookered, and in today’s repeat vote, it appeared that 8 of them flipped their vote. Kudos to the lobbies that strong-armed them. They were placed in a no-win situation of trying to defend the insurance companies against physicians and seniors.
The Democrats even had a flair for the theatrical, with Ted Kennedy dramatically returning for the vote.
So, what does it mean? Pretty much nothing. Instead of a 10.6 percent pay cut, physicians get a sub-inflationary 1 percent increase. There is another substantial payment cut next year, and we do this all over again. The entire payment system needs to be scrapped, and fundamental reform needed. Payments need to be divorced from volume, and the disparity between procedural and cognitive services has to be fairly reconciled.
However, this charade seriously damaged the Republicans. They pretty much crapped on the medical profession, a normally reliable ally. The appearance of defending insurance companies over the interests of physicians is inexcusable. The fact that McCain was absent from today’s vote spoke volumes.
In the eyes of this swing voter, this debacle will certainly weigh significantly come November.
{ 8 comments… read them below or add one }
Kevin you are totally right. All this vote did was prevent a bludgenning of physician pay today. Everything restarts tomorrow. The 20 republicans who voted no this time and John Mccain should be put on notice by physicians that they have made allies into enemies. I wish I had a link with the names and contact info for the twenty. We (physicians) as a group should also send out thank yous to the list of representatives and senators who voted yes on this measure and also remind them that this was a street fight and that there is a much much bigger issue to be raised about how the system works and what needs to be done to fix it.
Until they make it easy (or we as physicians) remove ourselves from being the center of the three party payor system (ie let the patient deal with their insurance company). Once the phyician is no longer contracted by insurance company, the patient can see the real value of their physician and any recommendations that are made. The patient then be incentiviced to find the best quality at the least price and make a jusgement call on that marginnaly useful $1000 test. This would result in cost savings for everyone.
Again, this is a small fight in a much bigger war and we should not let down our guard just because we averted todays crisis.
Like you said, it doesn’t mean shit. Now we’re looking at a 20% cut in 2010. That’s revenue. Account for inflation, medical expenses and overhead and your now looking at trying to avert a 50% cut in take home pay.
Yeah. What a great bill. Make it someone elses problem
I REALLY hope more of my physician colleagues read about this and understand how the republicans were siding against doctors. So many of them are so obsessed with their fears that Obama will either socialise medicine or raise their taxes or both that they forget about details like the fact that the GOP has been in bed with the insurance companies for a long time. I am sure McCain’s advisors told him to just not show for the vote to avoid screwing himself with us this Fall.
If this means “pretty much nothing”, why heap praise on the Democrats? This is all a political stunt wherein each party wants to humiliate the other; why congratulate anyone? We Americans are the losers, all of us, because there aren’t ANY politicians with any vision or original ideas about how to fix Medicare. Personally, I would have preferred the cuts take place, because I want to get on with the whole messed up system grinding to a hault, it can’t happen soon enough in my view. Maybe, MAYBE then we’ll all start talking about how to improve health care access and delivery in this country.
We docs are in a pitiful state; we’re now just another special interest group.
The doctor side of me cheers for the Democrats. The taxpayer side of me cheers for the Republicans.
As my wife said,”They’re going to tax me to pay you.”
This is not a win for physicians. All they got was a temporary stay of execution. The reimbursement cuts will be back in 2010, and they will stick next time.
The reality is that the docs (via the AMA) were duped into euthanizing their only real hope (market-based Medicare reform) of escaping the endless cycle of pay cuts and metastisizing Medicare regulations.
A 1% “increase” with 4% inflation means that all of us moron sheep physicians are cheering for 3% PAY CUT.
Everyone is missing the real point. The pharmaceutical companies are laughing all the way to the bank. It’s phamaceutical costs that is causing the squeeze in health care dollars. Then they dump the problem on the politically weaker physicians. No one in congress dares limit how much the powerful pharmaceutical companies charge for medications - and in fact allow them to charge more in the US than other countries. No one dares limit their shameless overpromotion of phamaceuticals. And yet its OK to squeeze the money to pay for that out of overworked doctors. Tell me what costs less today than last year?