The DJP Update

DJP Update 3-11-2010 Senate Parliamentarian “kills an option for moving health bill”; more about the quest for votes; Meanwhile AMA plans phone conf sometime in future

ITEM ONE: Senate Parliamentarian…

ITEM TWO: More about quest for votes

ITEM THREE: AMA plans “potential” phone conference… (and a few words from Senate Harkin about “SGR” and perhaps a fix “a few years away.”

ITEM ONE: Senate Parliamentarian states Senate bill must be passed and signed by President before Senate can act on a companion reconciliation bill.

DJP comment. If these media reports are correct, then the only way the Senate Majority can get around this is to have the U.S. Vice-President overrule the Parliamentarian OR fire the Parliamentarian and get one with a different view. Either would be a media disaster!

http://www.rollcall.com/news/44110-1.html

Ruling Kills an Option for Moving Health Bill

By David M. Drucker

Roll Call Staff

March 11, 2010, 2:30 p.m.

The Senate Parliamentarian has ruled that President Barack Obama must sign Congress’ original health care reform bill before the Senate can act on a companion reconciliation package, senior GOP sources said Thursday.

The Senate Parliamentarian’s Office was responding to questions posed by the Republican leadership. The answers were provided verbally, sources said.

House Democratic leaders have been searching for a way to ensure that any move they make to approve the Senate-passed $871 billion health care reform bill is followed by Senate action on a reconciliation package of adjustments to the original bill. One idea is to have the House and Senate act on reconciliation prior to House action on the Senate’s original health care bill.

Information Republicans say they have received from the Senate Parliamentarian’s Office eliminates that option. House Democratic leaders last week began looking at crafting a legislative rule that would allow the House to approve the Senate health care bill, but not forward it to Obama for his signature until the Senate clears the reconciliation package.

Meanwhile, Senate Majority Leader Harry Reid (D-Nev.) moved Thursday to put Senate Republicans on the defensive over health care, sending a letter to Minority Leader Mitch McConnell (R-Ky.) in which he dared the GOP to vote against reform.

——————–

Also see article about Parliamentarian at: http://www.businessweek.com/news/2010-03-11/health-care-bill-path-complicated-by-parliamentarian-update1-.html

Excerpt:

House Democrats are seeking assurance that the reconciliation changes will become law. Lawmakers in the chamber originally sought to have the Senate act first on reconciliation; then they wanted Obama to delay signing the 10- year, $875 billion Senate bill until the changes were passed.

Jim Manley, a spokesman for Senate Majority Leader Harry Reid of Nevada, declined to comment. Illinois Senator Dick Durbin, the No. 2 Senate Democrat, said on March 9 that he understands why some House Democrats might not want to trust that the Senate will act on the reconciliation changes.

‘Right to Be Skeptical’

“The House has a right to be skeptical,” Durbin told reporters. “They have almost 300 bills they’ve passed” that are “somewhere lost in the Senate.”

The news from Senate Republicans, who are unanimously opposed to the legislation, comes on the same day that House and Senate leaders said they had reached agreement on the majority of the language in the new reconciliation bill. The leaders presented the outlines of the plan to House Democrats today.

“The decisions are made, the choice has to be made” by lawmakers, House Speaker Nancy Pelosi told reporters.

Reid today formally notified McConnell that the Democrats plan to use reconciliation. Republicans say the process would be an abuse of Senate procedures.

————–

ITEM TWO: New information about the potential votes for and against the Senate bill when it gets into the House.

Dems Look To Health Vote Without Abortion Foes

The Associated Press

Erica Werner

March 11, 2010

http://www.ajc.com/business/dems-look-to-health-363244.html

EXCERPTS:

WASHINGTON — House leaders have concluded they cannot change a divisive abortion provision in President Barack Obama’s health care bill and will try to pass the sweeping legislation without the support of ardent anti-abortion Democrats.

——

“We will finish the job,” Senate Majority Leader Harry Reid, D-Nev., wrote in a letter to his Republican counterpart describing the path ahead.

Said Sen. Tom Harkin, D-Iowa: “The stars are aligning for victory on comprehensive health reform. The end is in sight.”

——–

ITEM THREE: AMA sent out an email to delegates and alternates under the name of the Speaker and Vice-Speaker (Sent: Wed, Mar 10, 2010 5:15 pm.) Unfortunately, as a former president of AMA who has a non-voting seat in the House of Delegates with microphone privileges, I am not on the email list for this information. Fortunately, one of the delegates on the DJP Update list sent it to me. In summary, the AMA email said things are “fluid” and

“The AMA will review the legislative language for the reconciliation bill promptly when it is finalized and made available. This work could be completed as early as next week. Wehope to convene an HOD conference call after we have reviewed and analyzed the final legislative language. Please watch your email for scheduling and logistical information on the potential upcoming HOD conference call.”

—–

DJP: Meanwhile “Rome is burning” and the U.S. House will vote the MOMENT the vote count gives a majority. That could be any hour. The closed doors will open and the vote will be taken. The AMA “potential upcoming HOD conference call” will be like ordering one more test on a patient who is bleeding and needs immediate operation. The patient may die in the interim. Decision-making is critical in leadership. If AMA came out against the onerous Senate bill, the bill would not pass in the House as AMA opposition would give “cover” to those Democrats who are on the fence.

Meanwhile, the big “SGR” negotiation has another surprise, namely the statement by Senator Harkin:

Date: March 9, 2010

© Inside Washington Publishers

Julian Pecquet and Seth Freedland

Harkin Acknowledges Permanent SGR Repeal Could Be A Few Years Away

A permanent ‘doc fix’ is unlikely this year and may have to wait a “couple, three years” for the federal budget to get in order, Senate health committee Chair Tom Harkin (D-IA) said Tuesday morning. The comments come just days after the American Medical Association sent a letter to Senate leaders saying it opposes a short-term payment patch of any duration.

Answering a question during a CQ/HealthBeat conference, Harkin said Congress “should have fixed it a long time ago,” but now “with the deficit as high as it is, it’s hard to think about taking all that money and moving it up front to fix the problem. It’s much easier to dribble it out a little bit at a time, year after year. But at some point, we’re going to have to bite the bullet.”

“Now, is that going to happen this year?” Harkin said. “I don’t think so. Hopefully if we get out of our slump in the next couple, three years, start moving up, then perhaps we can make some fix in that.”

—–

DJP Comment: I predict Senator Harkin is correct. There will be no permanent fix of the SGR this year! If that is what our AMA is waiting for in the negotiations, AMA will be waiting like the Spartans at Thermopylae. But the Spartans put up such a heroic fight that history remembers them for all time. AMA can be a powerful voice and a powerful actor. Time to act. Time to operate. Medicine is in shock. Words mean something but actions define the person and the organization. And yes, if AMA policy was passed into law, the right to privately contract without penalty, we would not have to spend a minute on “SGR” or other price-fixing schemes. The issue would be between politicians and the public. How long must we tolerate these abuses!

Today was my seminar I teach at Tulane Medical School entitled “Leadership in Medicine”. A good group of young, soon to be graduate doctors. I try to give them hope that Medicine can be saved from the politicians. Their future is bright if they are allowed to use their creativity and conquer diseases that we now can only offer comfort for. Let’s give them a chance and not shackle them.

Stay well.

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2221 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 3-9-2010 AMA & The Final Vote in Congress on Health System Reform; Background info DJPNEWS on Twitter

ITEM ONE: AMA & The Final Vote in Congress on Health System Reform

Tick Tock, Tick Tock; Time is of the essence. The advocates in the Administration and in Congress are having closed door meetings to try and get a majority vote in the House to pass the Senate bill. The moment the necessary number of votes are in favor there will be an immediate vote. As of this moment, there are not enough votes in the House of Representatives to pass the Senate bill. But lots going on behind the scenes. Remember the revelations when the Senate bill was passed as the public read the fine print of the 2700 page disaster in the details bill that emerged. Can’t get the book “Animal Farm” out of my mind when I review the actions of Congress: some are more equal than others.

Now our AMA. AMA has been silent of late as to AMA position of the vote about to be taken in the House of Representatives. AMA was not at the last President Obama press conference on stage with the other stage doctors and I did not see a representative of AMA in the audience of white coats.

It is time for AMA to state to the public and send a letter to Congress that AMA opposes the Senate bill. Do a clear and unequivocal press release that states opposition. All along AMA kept saying it is working to get changes in the bills. Well, the changes did not come.

One of many examples of items AMA opposed in the Senate bill. Still in the bill!

Independent Medicare Advisory Board

AMA policy specifically opposes any provision that would empower an independent commission to mandate payment cuts for physicians, who are already subject to an expenditure target and other potential payment reductions under the Medicare physician payment system. Therefore, we oppose the Independent Medicare Advisory Board as currently designed in H.R. 3590, and we look forward to working with you on significant changes to the proposal.

( This except above from AMA: http://www.ama-assn.org/ama/pub/health-system-reform/news/december-2009/ama-comments-hr-3590.shtml )

The better fix for payment is for AMA to boldly state no price-fixing by government! Let government decide what it can pay and let doctors and patients negotiate the rest. I am tired of people saying doctors can’t be trusted!

Time to enter the arena, AMA! Reread Shakespeare’s Henry V speech on St. Crispian’s Day:

————

We few, we happy few, we band of brothers;

For he to-day that sheds his blood with me

Shall be my brother; be he ne’er so vile,

This day shall gentle his condition;

And gentlemen in England now-a-bed

Shall think themselves accurs’d they were not here,

And hold their manhoods cheap whiles any speaks

That fought with us upon Saint Crispin’s day.

————

Time for AMA to enter the field of battle. Doctors are looking for warriors to save the patient-physician relationship and the Senate bill will not decrease cost, will not increase quality, and will give a false sense of access: an insurance card that has no doctor on the other end to do the treatment. In addition, the funny math will bankrupt this Country. Let this bill fail and put forth a bill that truly addresses the current problems. Allow health insurance purchase across state lines, get real proven medical liability reform and put some penalty on those attorneys who file suits without merit, use tax credits, convert Medicaid that currently is bankrupting states into a defined contribution, allow private contracting without penalty, and more: FOLLOW SPECIFIC AMA POLICY!

It is tough trying to convince members not to quit AMA. Give us some help, AMA!

ITEM TWO: Go to http://twitter.com/djpNEWS to see recent postings on the funny math Congress is using.

Especially see: DJPNEWS: Importance of analysis! RT @bridgettwagner How government lies about cost ’savings’ | Kyle Wingfield: http://bit.ly/bo7ix7

Stay well and a special welcome to the orthopedic surgeons in New Orleans for their annual meeting! Stop by the National WWII Museum here for a powerful reminder of the cost of Liberty.

http://www.aaos.org/education/anmeet/anmeet.asp

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2209 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 3-7-2010 Critical evaluation of British National Health Service by 3 organizations (IHI, JCAHO Int. & Rand) invited by British Gov to investigate; Lessons for U.S. Congress?

Below is tweet I sent out in early hours of this day as soon as the article came out in London.

“..ugly truth National Health Service” #NHS – Congress should read this article in #Times in UK http://tinyurl.com/yhdjy4c

——–

Alternative link to National Health Service story in the United Kingdom: http://www.timesonline.co.uk/tol/news/uk/health/article7052606.ece

Here is headline and some excerpts from article by Lois Rogers in Times of London. Read the entire article.

Labour hid ugly truth about National Health Service (NHS)

(DJP comment: This article is based on 3 reports from different organizations evaluating the NHS. The reports were obtained under a Freedom of Information request. The organizations: IHI of Massachusetts, JCAHO International, and the third report, by the US-based Rand Corporation)

DAMNING reports on the state of the National Health Service, suppressed by the government, reveal how patients’ needs have been neglected.

They diagnose a blind pursuit of political and managerial targets as the root cause of a string of hospital scandals that have cost thousands of lives.

The harsh verdict on the state of the NHS, after a spending splurge under Labour between 2000 and 2008, raises worrying questions about the future quality of the health service as budgets are squeezed.

One report, based on the advice of almost 200 top managers and doctors, says hospitals ignored basic hygiene to cram in patients to meet waiting-time targets.

It says “several interviewees” cited the Maidstone and Tunbridge Wells [NHS Trust in Kent where 269 deaths during 2005-6 were caused by infection with Clostridium difficile bacteria].

“Managers crowded in patients in order to meet waiting-time targets and, in the process, lost sight of the fundamental hygiene requirements for infection prevention,” the report stated.

There were subsequent failings at health trusts in Basildon in Essex, and Mid Staffordshire. Filthy wards and nurse shortages led to up to 1,200 deaths at Stafford hospital.

Lord Darzi, the former health minister, commissioned the three reports from international consultancies to assess the progress of the NHS as it approached its 60th anniversary in 2008. They have come to light after a freedom of information request.

The first report, by the Massachusetts-based Institute for Healthcare Improvements (IHI), identified the neglect of patients as a serious obstacle to improving the NHS. “The lack of a prominent focus on patients’ interests and needs … represents a significant barrier to shifting the trajectory of quality improvement in the NHS.”

——-

Some subheadlines in the article:

A damaging rift between doctors and managers.

Pointless new structures.

A culture of fear and slavish compliance.

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Note that the reports by IHI of Massachusetts and JCAHO International and Rand Corporation were done at the request of the British Government.

The IHI report, whose interviewees included Lord Crisp, chief executive of the NHS between 2000 and 2006, also described a system of self-assessment where only 4% of trusts are externally inspected.

———

A similar picture emerges in the second report, by the US-based Joint Commission International. It says the “quality and integrity of [NHS] performance data is suspect”.

Dennis O’Leary, its lead author and an international expert on patient safety and improvement…

——–

A Department of Health spokesman maintained that the three reports were never intended for “wider circulation” …

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DJP Comment: Lessons for U.S. Congress to learn?

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Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2207 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 3-4-2010 A message from 70,000 physicians to Congress about Medicare Payment System & The Right to Privately Contract without Penalty; and a few more things!

The letter below was sent today to the U.S. House of Representatives. The same letter was addressed and sent to the Senate Majority Leader Senator Harry Reid and the Senate Minority Leader Senator Mitch McConnell plus the entire Senate.

The message in the letter is long-standing AMA policy (since 1993) and among the highest advocacy issues of AMA as voted by the policy-making body of the AMA, the House of Delegates. (Reformatting of the names and addresses for this email)

The message also respects Liberty which has been the policy of These United States of America since 1776.

Stay tuned as the health system reform debate is nearing the holiday break of Congress and the sponsors of the senate and house bills are pushing for passage of these bills with disaster in the details prior to the March 29 – April 11 recess.

The focus is on the House of Representatives at the moment and you can be certain that a vote will be taken the moment the whip count shows enough votes for passage regardless of the day or hour. Lots going on behind the scenes in Washington, DC!

Call everyone you know in the House of Representatives and tell them not to pass the Senate bill! The vote could be very close.

March 4, 2010

The Honorable Nancy Pelosi

Speaker

The Honorable John Boehner

Minority Leader

United States House of Representatives

Washington, DC 20515 Washington

Subject: Medicare Physician Payment System and Private Contracting

Dear Speaker Pelosi and Minority Leader Boehner:

For nearly a year, the Coalition of State Medical and National Specialty Societies, representing more than 70,000 physicians, has expressed deep concern with the country’s broken and unsustainable medical payment system. Congress’ failure to adopt a permanent solution to prevent draconian cuts in Medicare payments to physicians affirms our concerns. Clearly, the current system is not financially sustainable. To help stabilize the Medicare system and ensure that seniors have timely access to care by the physician of their choice, we urge you to repeal the Sustainable Growth Rate and replace it with a new payment system that allows patients and physicians to privately contract without penalty.

The right to privately contract is a touchstone of American freedom and liberty and all patients should have the right to choose their doctor and negotiate the fees for those services without penalty. Medicare patients should not be required to forego the value of their Medicare insurance benefit because they privately contract with the physician of their choice; nor should physicians who privately contract with Medicare patients be required to opt-out of Medicare altogether for two years. Furthermore, in some instances, under current law it is actually illegal for a physician to waive or reduce his or her fee. By allowing patients to privately contract with their physicians, patients will have access to a greater number of physicians. In addition,

Congress can obtain budget certainty by establishing payment rates and giving physicians and patients the freedom to privately contract for any difference.

In closing, we believe that empowering patients and physicians with the right to privately contract is both an optimum and sustainable solution when it comes to the Medicare funding crisis. Please contact David Cook, Executive Director of the Medical Association of Georgia (dcook@mag.org 678-303-9251), if you have questions, need additional information or would like to discuss this concept in greater detail with the members of our coalition.

Thank you for considering our request.

Sincerely,

Medical Association of the State of Alabama

Medical Society of the District of Columbia

Florida Medical Association

Medical Association of Georgia

Kansas Medical Society

Medical Society of New Jersey

South Carolina Medical Association

American Academy of Facial Plastic and Reconstructive Surgery

American Association of Neurological Surgeons

American Society of General Surgeons

Congress of Neurological Surgeons

Daniel H. Johnson, Jr., MD

AMA President 1996-1997

Donald J. Palmisano, MD, JD, FACS

AMA President 2003-2004

William G. Plested, III, MD, FACS

AMA President 2006-2007

cc: Members, United States House of Representatives

——–

A few other items you may find of interest:

— Watch Senator Blanche Lincoln’s new TV ad. She says she doesn’t answer to the Democratic Party. Interesting.

https://secure.democratsenators.org/o/40/p/wfc/dscc/senators/lincoln/donate?donate_page_KEY=6518

— Read the transcript of the exchange between Paul D. Ryan of Wisconsin, ranking Republican on the Budget Committee, and President Obama at the Health Summit

Congressman Ryan is full of facts. The CQ transcript is posted at the Washington Post.

http://www.washingtonpost.com/wp-dyn/content/article/2010/02/25/AR2010022504074.html

— Some recent tweets you may enjoy; click on the links for the articles:

http://twitter.com/djpNEWS

#TomHanks toasts #NewOrleans”…most special place on planet”#NOLA.com at#WWIIMuseum movie ThePacific http://tinyurl.com/yjc3brk

about 12 hours ago via Echofon

Via #TheSaints New Orleans Saints turn New Orleans into America’s City – NOLA.com: http://tinyurl.com/ylomebx

about 14 hours ago via Echofon

Like a Greek tragedy play RT @washingtonpost #DavidBroder: The fable of Emanuel the Great: http://bit.ly/9WvXGi #Obama

about 14 hours ago via Echofon

RT @TheEconomist #BarackObama unveils his final strategy for pushing health reform in America http://econ.st/aXVugy#economist

about 14 hours ago via Echofon

Advantage of using #Twitter for news even when you don’t post tweets #NYTimes http://tinyurl.com/ygmbtqk

3:08 PM Mar 3rd via web

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2207 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 3-2-2010 Breaking news: SGR decrease delayed one month; H.R. 4691 temporary extension act passes; now goes to President for signature

http://twitter.com/djpNEWS

DJPNEWS

#Senate delays #SGR doctor payment cut 1 month with passage H.R. 4691 via @SenateFloor http://bit.ly/a8T3illess than 5 seconds ago via web

This temporary extension act also includes SGR in Section 5

Section 5 – (of H.R. 4691) summary

Amends title XVIII (Medicare) of the Social Security Act to extend through March 31, 2010: (1) the 0% update to the conversion factor in the Medicare physican payment computation; and (2) the Medicare physical therapy services caps exceptions process.

——

Full text of Sec. 5: http://www.govtrack.us/congress/billtext.xpd?bill=h111-4691

SEC. 5. INCREASE IN THE MEDICARE PHYSICIAN PAYMENT UPDATE.

Paragraph (10) of section 1848(d) of the Social Security Act, as added by section 1011(a) of the Department of Defense Appropriations Act, 2010 (Public Law 111-118), is amended–

(1) in subparagraph (A), by striking ‘February 28, 2010’ and inserting ‘March 31, 2010’; and

(2) in subparagraph (B), by striking ‘March 1, 2010’ and inserting ‘April 1, 2010’.

Senate Floor tweet:

On Passage – Senate – H.R. 4691: Bill Passed 78-19, 3 not voting. Bipartisan support. Go to Bill Status : H.R. 46…http://bit.ly/9wsWsV

http://www.govtrack.us/congress/vote.xpd?vote=s2010-32

Senate Vote On Passage: H.R. 4691: Temporary Extension Act of 2010

Number:

Senate Vote #32 in 2010 [primary source]

Date:

Mar 2, 2010 8:56PM

Result:

Bill Passed

———–

Stay well,

Donald

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2211 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.

DJP Update 3-1-2010 Press release about physician payment cut of 21% Medicare and a little more

Don’t forget the liberty right of contracting with patients for any differences that government pays, a right physicians do not have now unless the physician gets out of Medicare for two years! In my view, that should be part of every medical organization’s message to Congress and the American public. Price-fixing throughout history always leads to loss of access to service or product.

Press release follows:

FOR IMMEDIATE RELEASE Contact: media@protectpatientsrights.org

March 1, 2010 (703) 405-9407

MEDICARE BEING CUT TODAY

Biggest story in healthcare isn’t the reform bill, it’s that already-below-market physician reimbursement rates are being cut 21% today

WASHINGTON, DC – Due to Congressional inaction, Medicare’s reimbursement rates to doctors for their care of our nation’s elderly population will be cut a staggering 21 percent today. This is a result of an unwillingness or inability – pick your poison – to permanently secure the Medicare payment formula system or to even temporarily extend the patchwork fix already in place (the Sustainable Growth Rate formula or SGR). The Coalition to Protect Patients’ Rights supports a strong Medicare and a fair formula that will provide physicians with the resources they need to treat America’s seniors and also allow patients and physicians to negotiate any differences in cost to ensure patients get the care they need.

Former president of the American Medical Association and current spokesman for the Coalition to Protect Patients’ Rights, Dr. Donald Palmisano, made the following statement on the Medicare payment cuts:

“What are physicians to do? What are senior citizens to do?

“As Congress debates, seniors are at peril of losing the medical care they desperately need. Doctors are already providing care to the nation’s seniors at a reduced rate, but this latest cut makes treating those on Medicare financially impossible for doctors, nurses, and hospitals.

“And a one-time patch isn’t going to fix the problem for long. Although more than 40 million Americans rely on Medicare for their well-being and as enrollment is expected to explode as baby-boomers age and retire, Congress has recently proposed gutting Medicare – to the tune of $500 billion. There’s no way Medicare can be cut and still provide the medical service our most vulnerable populations need. Congress must fund Medicare so that it becomes solvent, pays physicians for the work and treatments they provide, and give seniors the peace of mind they deserve.

“Unfortunately, when medicine is subject to the limits of government-control and price-fixing, patients suffer. This isn’t just the case for Medicare, but also for Medicaid, or any other government controlled healthcare system – no matter what it’s called. Congress must do what it can to empower patients and physicians in healthcare, while limiting the role of bureaucrats.”

Dr. Palmisano is also available for interviews from New Orleans, LA, today. Please contact CPPR for more information (703) 405-9407.

About the Coalition to Protect Patients’ Rights

The Coalition to Protect Patients Rights is a non-partisan, grassroots coalition made up of over 10,000 doctors, healthcare providers, advocacy groups, and concerned citizens who are dedicated to the implementation of patient-centered healthcare reform that will improve patient care. For more information, visit the Coalition to Protect Patients’ Rights website at www.protectpatientsrights.org.

###

—————-

Meanwhile, others talk of the “the growing market power of hospitals and physicians to negotiate higher payment rates-”

DJP: The overwhelming majority of physicians have no market power!

The context of the market power of physicians comes from this article:

—————

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0715

While the high cost of private health insurance has drawn plenty of attention in the health reform debate, an underlying driver of higher insurance premiums–the growing market power of hospitals and physicians to negotiate higher payment rates–has gone largely unexamined, according to a Center for Studying Health System Change (HSC) study published online Feb. 25 by Health Affairs.

Funded by the California HealthCare Foundation, the study examines the growing market power of many California hospitals and physicians, finding that providers are using various strategies, such as tighter alignment of hospitals and physician groups, to negotiate significantly higher payment rates from private insurers. The authors point out that California offers a cautionary tale for reform proposals that encourage hospitals and physicians to form tighter relationships through accountable care organizations.

“Health insurers have been squarely in the crosshairs and blamed for the high cost of private insurance, while the role of growing hospital and physician market power has escaped scrutiny,” said HSC Senior Consulting Researcher Robert A. Berenson of the Urban Institute, a coauthor of the study with HSC President Paul B. Ginsburg and Nicole Kemper, a former HSC research analyst.

—————–

Stay well,

Donald

P.S. Stop by http://twitter.com/djpNEWS and sign up for DJPNEWS to get tweet alerts that may not make it into DJP Updates.

Also, recent selected DJP Updates can be found at: http://www.donaldpalmisano.com/html/djp_update/

Donald J. Palmisano, MD, JD
Intrepid Resources® / The Medical Risk Manager Company
5000 West Esplanade Ave., #432
Metairie, Louisiana USA 70006
504-455-5895 office
504-455-9392 fax
DJP@donaldpalmisano.com
www.donaldpalmisano.com
www.onleadership.us

This DJP Update goes to 2211 leaders in Medicine representing all of the State Medical Associations and over 100 Specialty Societies plus some other friends.
You can share it with your members and it has the potential to reach 800,000 physicians.
To join the list, send me an email stating “Join DJP Update” To get off the list, state “Remove DJP Update”. Best to put in Subject line so I can do immediately.