Docs Endorse Senate Health Care Bill, With a Warning

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Monday, December 21, 2009 at 3:06 pm

The American Medical Association, the nation’s largest doctors lobby, today put its weight behind the health reform bill likely to pass the Senate this week. But in its letter to Senate Majority Leader Harry Reid (D-Nev.), the group also warns that reform will be incomplete until Congress addresses the flawed funding formula that dictates Medicare payments to physicians.

The AMA firmly supports critical aspects of the bill that expand access to health insurance coverage, reform insurer practices, implement administrative simplifications, and promote wellness and prevention. … However, there is still work to be done. [...]

[B]efore any health reform effort, including this one, will prove successful, Congress must address Medicare’s fatally flawed physician reimbursement formula, the Sustainable Growth Rate (SGR). This bill relies heavily on the Medicare program to drive changes in provider and patient behavior in the health care system as a whole. However, delivery reforms and incentive policies will not effectively function while the SGR is still in place.

This is a stronger endorsement than the one AMA gave to the House bill earlier in the year, when the group hinged its support for health reform on an accompanying elimination of the SGR formula. That proposal passed the House last month, but Senate lawmakers killed a similar measure a month earlier because the $245 billion cost wasn’t paid for.

Recognizing that a permanent doc-fix isn’t happening this year, AMA decided not to attach the same condition to its endorsement of the Senate bill. Instead, it attached a warning: Congress — which recently approved a 60-day patch preventing Medicare payment cuts to docs as part of its defense spending bill — must return early next year with plans to provide a permanent solution to the perennial problem.

Physicians, and increasingly patients, are rapidly losing faith in the ability of Congress to address this critical issue. It is for that reason that the AMA will oppose efforts to apply temporary band-aids beyond the 60-day extension included in the FY 2010 Defense appropriations bill. Congress must replace the SGR early next year in order to achieve the access, payment and delivery reform goals envisioned by H.R. 3590. We will not support a final Conference Report without a clear pathway for passage of a permanent repeal of the SGR formula early next year.

The doc-fix issue leaves Democrats in the awkward position of having to return to health care next year just a few weeks after they’re likely to enact the most expansive health reforms in 44 years.

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