A New York Times editorial outlines and opines on the differences between the House and Senate HSR legislation. Their opinion is wrong on two provisions that affect physicians:
- They note that the House bill relies heavily on Medicare pilot projects to determine which approaches to restraining medical costs might work best. The Senate bill would, instead, empower an independent board to carry out 'successful reforms broadly within Medicare and recommend changes in private programs'.
The Times prefers the Senate bill because the House bill lacks a strong mechanism, like an independent board, to drive successful reforms into widespread use.
The Times incorrectly characterizes this board as a 'crucial cost-control mechanism'. This opinion is misguided because we've essentially been doing this for the past 30 years - only we've called it managed care.
Simply granting an 'independent board' authority is insufficient. After all, Medicare pilot projects have been ongoing for more than ten years! Sustainable, effective cost control will require integrative strategies and they'll need to be physician based. Physicians are truly the only entity, once empowered, that can initiate and sustain cost containing/integrative reforms.
- The House Bill provides for the paying of primary-care doctors the same (amount) that Medicare pays.
The assertion that this would make it more likely that poor patients could find a doctor is spurious - inadequate reimbursement, albeit more generous, would still be inadequate. Just look at the access problems faced by (and those that threaten) the Medicare population currently.
Journalists and elected officials could better serve their clients were they to consider the vast experience of the provider community when they prepare their opinions. Some folks would refer to that as 'evidence based.' As in industry, a quality health care initiative (like the principles of six sigma) , ought to be driven by a commitment to making decisions on the basis of verifiable data rather than mere assumptions and guesswork.
No worries ... it seems the Democrats will bypass the usual House-Senate Conference Committee.
ReplyDeleteBut aren't you happy we're "at the table?"
HMO's and Pharma are now lobbying hard to preserve the Dem's 60th Senate vote in MA.
ReplyDeleteAll the leading drug companies have lobbyists on Coakley’s host committee: Pfizer, Merck, Amgen, Sanofi-Aventis, Eli Lilly, Novartis, Astra-Zeneca, and more. On the insurance side of things, Blue Cross/Blue Shield, Cigna, Humana, HealthSouth, and United Health all are represented on the host committee.
Those HMOs (like Aetna) or drug companies who don’t have lobbyists in Coakley’s top tier of fundraisers? They’re covered, because the host committee includes four lobbyists representing the Pharmaceutical Researchers and Manufacturers of America (PhRMA), two representing America’s Health Insurance Plans (AHIP), and one representing the Biotechnology Industry Organization (BIO)
So think of these top donors to health-care reform’s 60th vote next time President Obama claims that he’s battling the special interests in this battle. The army listed below is on Obama’s side, and these clients will all benefit from “reform.”