The Republican bill leaves out a number of the key features of the Democrats' legislation (and thus does too little to alleviate the problem of the uninsured):
- It does not require employers to insure their employees
- It does not require nearly all Americans to purchase insurance
- It does not block insurers from denying coverage to people with pre-existinghealth conditions
Instead, the Republican plan
- increases incentives for people to use health savings accounts,
- caps non-economic jury awards in medical malpractice cases at $250,000,
- provides various incentives to states with the aim of driving down premium costs and
- allows health insurance to be sold across state lines.
Link to Boehner Bill (Med Mal pp 150-169)
AMA's Nancy Nielsen on Fox:
ReplyDeletehttp://www.youtube.com/watch?v=Oj7lTr_zPtA&feature=player_embedded
PM writes:
ReplyDeleteMy friends and colleagues want the SGR fixed, tort reform, hassle-free commercial claim policies without hidden agendas, and a fair fee schedule for participation in network.
We should not be losing 20-30% of our payments to insurance company tricks, nor should we be chasing after hidden co-insurance balances that are part of our "allowed" fees.
Our patients are frustrated and we are frustrated. Is the AMA backing these concerns or settling for empty promises of a 'fix' someday?
JM writes:
ReplyDeleteI'm at the ... Airport awaiting to depart for Houston to attend the interim meeting of the AMA.
I empathize with your frustration. It is difficult to keep abreast of all these pieces of legislation which are each over 1,000 pages. How can any physician read through all of them? What is the incentive to even start when the bills are constantly changing?
... I'm hoping to get some clarity this weekend as we learn what are the key points being thrashed about in the debate. There will be a number of us there and hopefully, we will come out of this with greater clarity rather than more frustration.
If anything, I admire all the folks who are still hanging on in this long ordeal. ... The temptation is great to just give up and begin preparing the bunker ...
We have no other (better) voice at this time than the AMA.
Hopefully, the physician leaders present at the meeting will be able to come to some consensus with a margin large enough to send the message that the House of Medicine is speaking with a strong voice. Otherwise, our opponents will use the lack of cohesiveness against us.
MS writes:
ReplyDeleteWell JM, I beat you here.
(I) Just heard Cecil Wilson (President - elect) speak about the AMA's recent endorsement.
The AMA Board decided after much deilberation that these 2 new bills did indeed adhere to the 7 principles oulined by the HOD as being a must for any bill.
Those being:
-Health Insurance for All Americans
-Insurance Market Reform and expanded choice and elimination of denials for pre-existing conditions
-Assurance that health care decisions will remain in the hands of patients and their physicians
-Investments and incentives for quality improvement and wellness initiatives
-Repeal of the SGR
Implementation of medical liability reforms
-Streamlining and standardizing of insurance claims processing
We've heard it emphasized that there will not be a public option tied to Medicare (fees).
We have also heard that the second bill gives us a permanent fix to the tune of $450 billion and ties medicare to the MEI instaed of SGR.
My personal fear is passage of the first and not the second.
Most of us remain fearful of the Single Payor threat.
Dr. Wilson did go on to point out that he feels we are far from End Game here and that there still remains great opportunities for mischief before we ever see a final bill.
It will be a fun weekend!
TF writes:
ReplyDeleteI agree ... about the Republican plan. I like it better than the Dems plan but failure to cover pre-existing conditions is major flaw.
If they had included this it would be hard to criticize.
One specialty society released this today:
ReplyDeleteWe understand that no single piece of legislation is perfect.
The ACS and 18 other surgical groups ..noted that without changes, (they) would oppose the Senate’s health care reform bill.
The Senate bill includes troublesome provisions including:
* An independent Medicare advisory commission that is charged with cutting Medicare spending by 1.5 percent per year
* A 5 percent penalty for the top 10 percent of physicians who are resource-use outliers
* Penalties for non-participation in Medicare’s Physician Quality Reporting Initiative (PQRI)
H.R. 3962 is the ... health care reform bill that would expand coverage, promote and incentivize high-quality care and maintain a pluralistic health care system. The bill includes key provisions ...
* Does not create an independent Medicare payment advisory commission
* Provides a bonus for primary care that is not paid for by cuts to specialties
* Exempts ultrasound and other in-office procedures from major imaging payment cuts
* Preserves voluntary participation in PQRI
* Requires pilot testing of new physician payment reform ideas, such as accountable care organizations (ACO)
* Makes physician participation in the public insurance plan optional, and allows negotiated rates to pay no less than Medicare rates in effect
* Provides grants to test alternative liability reforms at the state level, while protecting current, stronger state laws that include caps and other limitations
Because of the likelihood of problematic provisions in the Senate legislation, the House position must be especially strong during the House-Senate reconciliation effort.
PS writes:
ReplyDeleteAlthough I, as a single payer supporter, disagree profoundly with many other(s) ... on how to reform the health care system, I DO agree with PM's (comment) and suggest we send it, or a similar message, to the AMA leadership.
The Column A/ Column B approach would have been truly bipartisan and truly historic ... which is why it was not adopted.
ReplyDeleteOn pg 1291, Healthcare workforce is defined to include veterinarians.
ReplyDelete