On a NY Times blog was this entry regarding the politics of S 1776:
'(Providing an SGR fix), ... in legislation separate from the big health care overhaul, is raising uncomfortable questions for President Obama and for Democratic leaders in Congress ...
(This is so, because they) promised that revamping the health care system would not add to the nation’s deficits.'
Physicians recognize that the flawed SGR, and Congress's repeated 'patches' over the years, are essentially a 'loan'. Repayment of this loan, which itself derives from flawed budget legislation from 1997, does not in any way redress the current health care system problems of the uninsured and of expanding access. It would thus be illogical to consider this cost in the same breath as true Health System Reform.
If more docs leave medicine, having insurance won't mean a thing.
ReplyDeleteOT: If the Govt can't run an Energy Star Program, why do we think they can run one-sixth of GDP?
ReplyDeletedoc 99, your sense of humor is ever present.
ReplyDeletethe goverment will not run one-sixth of gdp. one proposal, that for a public option, is to have the govt manage a plan that will pay for mostly private care by private providers - same as care is provided now.
the public option will apply to people who either have no coverage or are unhappy with their current coverage - say 1/4 of folks? (that works out to 1/24 of gdp).
but the point of today's post is that an SGR fix is vital and necessary. however, the cost of the fix is associated with care that has already been rendered (since 1998) and should thus not properly be attributed to health care reform going forward. the senate strategy (so far) has it right.
PV, it appears the Administration is conflicted on a Government plan.
ReplyDeleteOK ... so now that we have the 1502 pages of Senate Finance Bill, we see what will be substituted for the current SGR:
ReplyDelete... (1) IN GENERAL.—The Secretary shall establish a payment modifier that provides for differential payment to a physician or a group of physicians under the fee schedule established under subsection (b) based upon the quality of care furnished compared to cost (as determined under paragraphs (2) and (3), respectively) during a performance period.
‘‘(3) COSTS.—For purposes of paragraph (1), costs shall be evaluated, to the extent practicable, based on a composite of appropriate measures of costs established by the Secretary (such as the composite measure under the methodology established under subsection (n)(9)(C)(iii)) that eliminate the effect of geographic adjustments in payment rates (as described in subsection (e)), and take into account risk factors (such as socio-economic and demographic characteristics, ethnicity, and health status of individuals (such as to recognize that less healthy individuals may require more intensive interventions) and other factors determined appropriate by the Secretary.
Dr. Hobson, please call your office.
Page 699.