Last week, the Missouri State Medical Association issued a statement opposing the Senate Health Care Reform Proposal based upon a number of considerations. The statement is available on the website at
www.msma.org.
The Board of Directors of Metro Med met this past Monday evening and voted to endorse the MSMA position without any qualification.
In the short time that has passed since that meeting, a lot has happened on Capitol Hill in Washington D.C.
On Tuesday, the Medicare "buy-in" proposal for persons between ages 55 to 64 was jettisoned;
Wednesday, the House of Representatives voted 395-34 to approve a fiscal 2010 defense appropriations bill that includes a measure to stave off Medicare physician payment cuts until (and only until) March 2010;
The number of amendments proposed to the Senate bill now total up to 431; it is inconceivable that these could be given due deliberation in a mad rush to get legislation passed prior to year-end.
We at Metro Med remain very concerned about the key issues outlined in the MSMA statement, and are skeptical that enough careful consideration is being given to these issues by legislators.
For example:
The SGR payment formula (with its associated legislative mandates) needs to be fixed permanently, once and for all. Another "quick-fix" solution reflects very poorly on our Congress;
There is great potential for rapid expansion of regulation and bureaucracy, with empowerment of a super-MedPAC that is no longer accountable to Congress, and broadening the scope of authority of the Secretary of HHS. Pilot projects exploring newer reimbursement methodologies via Accountable Care Organizations (ACOs) might be rapidly expanded if the Secretary wishes to do so. Yet, in a survey that we (Metro Med) just issued, the vast majority of respondents didn't even understand the concept of an ACO. Nor did respondents support the idea of fixed, bundled payments to hospital-physician organizations.
We think a "TIME-OUT" is in order here to assure access to quality care for our current patients. We physicians now do such "time-outs" prior to every procedure as part of our routine focus on patient safety; why not the same process for this major, "surgical" piece of legislation with its far-reaching implications.
