• Reflex: December 21, 2011

    Kicking the decision about what benefits must be included in individual and small-employer plans to states will continue the nation’s patchwork of uneven coverage, report Gardiner Harris, Reed Abelson, and Robert Pear. “People in Utah and Wyoming, for example, are likely to have more limited access to expensive services now mandated in states like Massachusetts and Maryland — at least until 2016, when a senior administration official said the federal government plans to establish a national standard of essential benefits.” Austin’s comment: I’m getting a lot of questions as to whether this was a good or bad move by the Obama Administration. One thing is clear, it was a politically wise move. Dodging another huge fight over health reform may aid the viability of the new law in the long run.

    Yes, Congress didn’t pass a deal to extend the Payroll Tax deal, but that also means they didn’t pass a temporary doc fix, writes Julian Pecquet. “Patient advocates immediately started blasting Congress on Tuesday after House Republicans nixed a temporary fix to Medicare payments to physicians. The House voted 229-193 to reject the Senate’s two-month “doc fix” and instead call for a conference meeting with the Senate. Senate Majority Leader Harry Reid (D-Nev.) says the Senate is done for the year. If neither chamber changes its mind, physicians will see a 27.4 percent cut in Medicare payments starting Jan. 1.” Aaron’s Comment: There’s no “if” there. The Senate has gone home for the holidays, and the House has voted. There will be no doc fix before the new year. This doesn’t mean that one own’t be passed retroactively, but it’s got to be frightening for the AMA and others. If Congress is willing to play chicken with all of America, I don’t know why they wouldn’t with physician reimbursement.

     

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    • -The more of the tab that the government is picking up for health care, the greater the pressure will be on physician reimbursement. The fiscal pressures are enormous and unrelenting, and no one weeps for folks who bring home six-figure-plus paychecks no matter how hard they work for them.

      In the meantime, everyone in the field should do what they can to minimize their personal and professional cost structures. Once the reimbursement rates drop so low that a critical mass of physicians refuse to see Medicare patients, expect taking them to be a precondition for licensure.

      There are plenty of folks that are walking to this eyes-open in order to see their dream of centrally planned and administered healthcare realized, but I’m mystified by folks who find the prospect of reduced reimbursement surprising and/or shocking.

      It’s coming.