GOP, Some Dems object to plan for adjusting physicians' medicare pay

Oct 19 2009

Senate Democrats next week will take up a $240 billion, stand-alone bill that would stop scheduled cuts in Medicare's payments to physicians, The Hill reports. Although the action would be separate from sweeping health reform legislation, "[f]ixing the physician payments could boost Democrats' health reform efforts by providing physicians with a win on their foremost priority. ... Republicans countered that the Democrats' plan to use deficit spending to pass the physician payments bill underscored the GOP's contention that the majority party does not intend to fully pay for its healthcare legislation this year" (Young, 10/15).

Meanwhile, "A revolt among Democratic fiscal hawks could lead to the defeat of" the pay fix plan, CongressDaily reports. "Several moderates said [Thursday] they will vote against the bill if it does not include a pay-for to offset the $245 billion cost of the bill." Although leading senators characterized the bill as a minor change to "baseline budget assumptions," Sen. Kent Conrad, D-N.D., the moderate chairman of the Senate Budget Committee, "said that is not the case" (Edney, 10/15).

The Hill reports in a second story that in April, House Speaker Nancy Pelosi and other top Democrats pledged to pay for legislation involving any of four key areas: "middle-income tax cuts, estate tax adjustment, Alternative Minimum Tax relief and the 'sustainable growth rate in Medicare,' known as SGR or the doctor's fix." Pelosi promised the fiscally conservative "Blue Dog" Democrats to stand by that pledge on Thursday (Allen, 10/15).

Whether they get the pay fix or not, "[i]t's hard to feel sorry for America's family doctors," who average $179,000 a year, TIME reports. "Do we simply pay doctors too much?" may be the wrong question. Instead, TIME suggests that how they area paid is a broader problem. The "so-called fee-for-service tradition has contributed to the dysfunction of the U.S. health-care system." TIME reports, "Overhauling fee-for-service may well make medicine less lucrative for some practitioners. But it would give others a new opportunity to practice medicine in an almost forgotten way: getting to know their patients and keeping them healthy so they can avoid a surgeon or a hospital" (Kluger, 10/15).