Monday, June 28, 2010

Some facts about health care reform

Richard Reece, author of Obama, Doctors, and Health Reform posted over at, Why Obamacare scares this Cardiologist. He discussed a conversation with his cardiologist about President Obama and how recent health reform legislation was impacting Cardiology and failing to cut health care costs.

I posted my thoughts on the matter below:

I could not agree more, that PPACA does little, if anything to reduce the health care costs. While the CBO has projected federal cost savings a decade from now, we will have to see whether their math bears fruit. In the meantime, however, some other discussion is appropriate.

PPACA, the bill that passed this year has numerous provisions that will change the way health care is delivered in this country. Depending on your role as a patient, physician, insurer, etc. some of those reforms are good and some are not.

Let us separate out some facts, however.

First, the $565 billion being "cut" from Medicare is largely cutting kickbacks to insurance companies through the Medicare Advantage program. It is not directly cutting costs for benefits OR for physician reimbursement.

Second, the cuts to physician reimbursement were completely removed from the health care bill (PPACA) due to the high cost of replacing the SGR ($250 billion). The Obama administration, however, tried numerous times to pass "the doc fix", both as a provision of PPACA, and as a separate bill. Both of these efforts were blocked by... the Republican party (and some blue dog Democrats).

Third, the "40%" cut for Cardiologists one of two things, and I am not sure what you are referencing. Either it is a cut in reimbursement for nuclear stress tests or a compound cut  involving the 21% cut from the SGR and a second 20% cut that CMS has proposed based on flawed practice cost survey data. Neither of these were proposed or carried out by the Obama administration, they are CMS initiatives. Now, admittedly, Obama could potentially pressure CMS into changing their tune, but I doubt he has the desire or fortitude to insert himself into disagreements between physician specialties. 

Health care reform should not be a partisan issue, but the same assertion could be made for numerous topics that Washington chooses to opine on. Unless physicians are engaged in the process, however, Washington will legislate and regulate as they see fit and they will do so in response to the other players in health care that do choose to engage. 

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