DJP Update 11-23-2010 Ink Wars: Wall Street Journal (WSJ) & American Medical Association (AMA) – “The Doctor Con” vs “Have You No Sense of Decency…”
WSJ tweet found at: http://twitter.com/wsjopinion
ONLINE.WSJ.COM – The Doctor Con: The AMA gets its payment fix—for all of four weeks. http://on.wsj.com/9CZ9dS
You may be able to find and read the entire article at this link:
http://online.wsj.com/article/SB10001424052748704170404575624643400449172.html
WSJ article:
- REVIEW & OUTLOOK
- NOVEMBER 22, 2010
The Doctor Con
The AMA gets its payment fix—for all of four weeks.
One of the tragi-comic sideshows of passing ObamaCare was the Democratic attempt to buy off the American Medical Association by promising a permanent fix to the Medicare payment formula for doctors. Apparently permanent is four weeks.
That’s the upshot of last Thursday night’s Senate vote to postpone an automatic 23% cut in Medicare physician payments, but only through New Year’s Day. The House plans to approve the same deal next week, and you should think of this as Nancy Pelosi’s housewarming gift for Speaker-presumptive John Boehner.
Democrats got their AMA endorsement of ObamaCare from immediate past president James Rohack, who was last seen leaving the Beltway on a turnip truck. But Democrats left a permanent fix out of the final ObamaCare bill in order to keep the official price tag below $1 trillion. Democrats planned to pass the $250 billion “doc fix” later in a separate bill, but somehow they never got around to it. Even liberals can’t always conjure up a quarter-trillion dollars on demand, and some Democrats wanted the fix “paid for” with other spending cuts, real or invented.
The result has been a string of temporary last-minute reprieves. This will be the fourth this year, which is even worse than the annual “doc fix” fire drill that prevailed under both Democrats and Republicans until ObamaCare sopped up all the easy budget money. The Senate’s latest one-month version costs $1 billion and is paid for by claiming to reduce certain outpatient therapy payments by about $100 million each year for the next decade. Anyone willing to bet on whether those cuts will ever happen? We’ll take the “no” side of that wager.
In sum, Democrats deceived the AMA about the doc fix and are now deceiving voters about how they’ll pay for even this four-week reprieve. And they’re dumping the $250 billion bill on Republicans.
This doctor-payment charade has served both parties since it was created in 1997 as a palm-greaser for campaign contributions and to disguise the real costs of Medicare as part of the Bill Clinton-Newt Gingrich balanced budget deal. But these Democratic abuses are something else. Three of the four stopgaps this year have passed after the deadline set by the previous stopgap, so for a time Medicare simply stopped paying doctors, causing back-office disruptions nationwide. Imagine if a private insurer pulled these stunts.
A more stable payment system that reflects the real costs of delivering medical care while reining in federal health spending would mean dumping the Medicare price-control model that has led to the current mess. A good place to start are Wisconsin Republican Paul Ryan’s Medicare reform ideas, which were endorsed last week by no less than the long-time Democratic budget hand Alice Rivlin. Maybe now that the AMA has been exposed as fools one more time, its new leaders will support genuine reform.
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AMA RESPONSE (VIA AMA PRESIDENT)
Blog: On the Road with Dr. Wilson
Have you no sense of decency, sir?”
Posted at 11/23/2010 12:00 PM CST
An editorial in the Wall Street Journal yesterday—denigrating the AMA’s role in the health system reform debate and the current Medicare mess—talked about buy-offs, deception and being treated as fools. It was obviously an opinion piece and thus unfortunately not necessarily subject to the rules of accuracy or facts. That being said, it was breathtaking in making assumptions and drawing conclusions about events that never happened—that bear no resemblance to reality.
In a time when everyone is castigating politicians for being partisan, it struck a new low in a harsh note of discord that does not add to responsible debate on how this country can improve our health care system. It was a diatribe more suitable to the proverbial muck-raking tabloid than to a venerable news organization.
To set the record straight, Democrats and Republicans share responsibility for the combined steep 25 percent Medicare cuts to physicians that loom ahead. There is bipartisan understanding that the current Medicare physician payment system is fatally flawed, yet both political parties allowed the problem to grow, increasing the cost of permanent reform from $48 billion to more than $250 billion. Both Republicans and Democrats have said the problem needs a real solution but neither has delivered.
The AMA’s focus—before, during and after the health system reform debate—has been to ensure that physicians can continue to deliver high quality patient care. More thoughtful problem-solving and less partisan sniping is the way to make our health system work better for patients and physicians.
The Wall Street Journal editorial puts me in mind of an event on June 9, 1954, when Sen. Joseph McCarthy was using his position as chair of the Senate Committee on Government Operations to destroy the careers of many people by being “judge, jury, prosecutor, castigator and press agent, all in one.”
This came to a head during one committee hearing when the senator was being particularly vicious in a vendetta against the Army, unfairly attacking a witness and attempting to destroy his reputation. Joseph Welch, the attorney representing the Army (and the witness), went on the offensive against Sen. McCarthy, saying: “Until this moment senator, I think I never really gauged your cruelty or your recklessness. Senator you’ve done enough. Have you no sense of decency, sir? At long last, have you left no sense of decency?”
So, I say to the Wall Street Journal …?
Do you have a question or a concern you would like to be heard? If so, and if you’re an AMA member, join me for my next “Office Hours” at 7 p.m. Eastern time on Wednesday, Dec. 1. Register today.
Editor’s note: To comment on this post, send us an e-mail.
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AMA also sent out a tweet about this posting. It is found at: www.twitter.com/AmerMedicalAssn
AmerMedicalAssn AMA
#AMAblog Dr. Wilson: an editorial from yesterday’s Wall Street Journal bears “no resemblance to reality.” http://bit.ly/fdSALw
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LAGNIAPPE: Meanwhile, this came out of the AMA Interim Meeting as part of AMA’s Strategic Plan. It needs to be implemented! Allow private contracts without penalty and get rid of IPAB!
EXCERPT:
There is no question that achieving a lasting and adequate solution to the SGR is a cornerstone to successful innovation with other new payment models. In collaboration with state and national medical specialty societies, the AMA will continue to press Congress to repeal the SGR and replace it with a stable funding policy that reflects increases in the cost of care. Work is also underway to remove current restrictions in Medicare law to allow patients and physicians to enter into private contracts without penalty to either party. The federal government should not restrict the ability of patients to spend their personal funds to preserve access to their physician of choice.
Eliminating the Independent Payment Advisory Board (IPAB) authorized by the Affordable Care Act is a top AMA priority in 2011.
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Too bad that was not mentioned in AMA’s 11-8-2010 column “On The Road” discussing the strategic plan.
| AMA’s strategic plan focuses on five key issues
Posted at 11/8/2010 11:30 AM CST |
http://www.ama-assn.org/ama/pub/ama-president-blog.shtml?plckController=Blog&plckBlogPage=BlogViewPost&UID=0b90b13b-8074-42d2-be9a-5d263dc8c945&plckPostId=Blog%3a0b90b13b-8074-42d2-be9a-5d263dc8c945Post%3a3653f33d-a47b-4d5e-b65c-d2d44f28fdf1&plckScript=blogScript&plckElementId=blogDest
The above excerpt is in the Board report at Interim Meeting in San Diego but only this gets put into the column:
“2. Next generation physician payment: Aligning incentives with quality of care while covering the cost.”
A top priority of AMA should be mentioned boldly, in my opinion.
Well, still have a wonderful Thanksgiving. We will overcome. But we must focus! And execute. Rhetoric is nice but action defines us.
Stay well,
Donald
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