Physician Payment Reform - the First (Real) Trial Balloon
Wednesday, May 6, 2009 | 0
By Joe Paduda
Last week's revelation of a compromise on health reform by two key Senators - a Republican and a Democrat - was the first public statement of the long-simmering plan to significantly change physician reimbursement.
It wasn't much to start: A call to increase reimbursement for primary care services by 5% along with bumps in payments to rural physicians. But is also noted a decrease in reimbursement for other specialists. And that's where things are going to get very contentious.
The proposal by Senators Max Baucus (D-Mont.) and Charles E. Grassley (R-Iowa) indicates there's been significant progress between the two parties on health reform; according to The Los Angeles Times, "the senior members of the Senate Finance Committee have reached some bipartisan agreement about how the federal government should pay providers through its Medicare program."
This bipartisan agreement, coupled with the earlier announcement of Sen Arlen Specter's move to the Democratic party and the decision by Democrats to subject health reform to the reconciliation process (where it can pass the Senate with a simple majority) may well kick health reform into high gear. Politically, more Republicans may be realizing that a continued policy of pure obstruction will not help turn around the fortunes of the party.
With health reform a highly visible issue, at least some members of the minority party may have decided to try to steer the bus instead of continuing to lie down in front of it. Politico recently reported that Rahm Emanuel met with Senate Minority Leader Mitch McConnell to discuss health reform - a meeting that may well indicate the GOP leader is willing to engage.
I'd expect there is some serious horse-trading going on in the back offices, and one of the chips is very likely the public plan option. If the Rs can keep that off the table in return for their acceptance of other health reform provisions, we just may see reform this year. As I've noted repeatedly, the protests over the public option are generally overblown. Be that as it may, killing the public option would enable Rs to claim a significant victory and retain some political capital amongst their core supporters.
What does this mean for you?
Watch what key Democrats say about the public option; a cooling of enthusiasm may well indicate a compromise is in the offing and reform may actually happen.
OK, so the Dems will have more control over legislation when (Minn. Senate hopeful Al) Franken joins the Senate. With Pa. Sen. Arlen Specter changing sides, they have passed the magic 60-vote threshold, making it theoretically possible for health reform legislation to pass without any votes from the other side of the aisle.
'Theoretically' being the operative word.
Before anyone starts chilling the champagne and covering the lockers with plastic, think about what hasn't changed; health care reform - as currently conceived - is unaffordable.
None of the recent developments - or any of the current proposals (except the Wyden/Bennett Healthy Americans Act) do anything to resolve the cost issue.
To listen to the Glen Becks/Sally Pipes/Charles Krauthammers/Neil Cavutos you'd think President Barack Obama and the Democratic Congress is 100% full-bore absolutely committed to a health system run by the Feds - Where all docs are federal employees and hospitals are owned by the "gub'mint."
They are nothing if not consistent in decrying 'socialized medicine,' unfortunately they have no idea what they're talking about. Nowhere in President Obama's history - not in any position papers, speeches, responses to questions, or writings - is there any credible evidence of any support for a socialized health system (one where the payers and providers are government workers).
Nowhere.
This isn't a "you say po-tay-toe, I say po-tah-toe" thing. We are not splitting hairs arguing about policy niceties or nuance, this is a flat out complete distortion of the Democratic reform platform. It is an active, aggressive, coordinated, consistent effort on the part of these wingnuts to distort the Democrats' position and scare Americans. These right wing talking heads are not idiots, and they can read; clearly they know they're lying.
Why?
Simple - the real Obama/Democratic health reform plans aren't scary big government takeovers of health care; they leverage the existing private insurance industry - and don't even assure universal coverage.
In fact, the voters might actually like the Obama plan. What's unfortunate is by lying about the Dems' reform initiatives, these folks have lost all credibility. They could contribute to the discussion, instead they're standing on the side lines screaming.
What does this mean for you?
If the Dem's plans were that bad, the wingnuts wouldn't need to lie about them.
======
Joseph Paduda's blog, managedcarematters.com, focuses on managed care for group health, workers compensation, auto insurance, cost containment, health policy, health research, and medical news for insurers, employers, and health care providers. Paduda is the principal of Health Strategy Associates.
======
Comments