Senate Vote Paves the way to SGR Reform

From AMA Advocacy Update:

On January 28, the Senate passed H.J. Res. 45, a resolution to raise the federal debt limit along with several limited exemptions to the PAYGO rule. This includes exception for addressing the Medicare physician payment cuts about to be produced by the sustainable growth rate (SGR) formula.

This action means that up to $82 billion spent for an SGR fix would not have to be offset by other revenue or cuts. This amount could fund a five-year freeze. Thus, some have characterized the SGR exemption as a five-year freeze.

The House is expected to take up and pass H.J. Res. 45 this week. Congress must still enact separate legislation to stop the SGR cuts prior to March 1.

To obtain permanent repeal of the flawed payment formula, the PAYGO exception must be accompanied by an additional $130 billion in budget offsets.

AMA position: The AMA continues to insist that Congress pass legislation to permanently repeal the SGR.

Health Care: Too Big To Fail?

Paul Volker wrote in the New York Times today of 'the implication that really large, complex and highly interconnected .... institutions can count on public support at critical times'. He refers, of course, to the financial sector.

Are there parallel lessons that apply to the health care sector (and to health system reform)? Certainly the health care sector, as well, is 'too big to fail.'

Leadership? MIA for Now

President Obama indicated that he might be willing to scale back his proposed health care overhaul to a version without provision for near-universal insurance coverage. Speaker Pelosi says the House wants 'comprehensive reform' and (thankfully) won't pass the flawed Senate bill.

While Massachusetts enjoys the lowest percent of population without coverage (about 5%) and Texas enjoys the highest (about 25%), Californians now talk of reintroducing universal single payer legislation in order to eventually save money.

While White House officials and Democratic Congressional leaders still struggle to find a viable way forward for the health care bill, your blog-masters ask, "Where is the national leadership here"?

Everyone seems to agree that some reform is needed. But nobody needs a compromise for sellouts and lobbyists. What about true leadership, and what about a physician voice?