Congress Hoisted On Its Own Petard

For ‘tis the sport to have the enginer
Hoist with his petar.

Shakespeare, Hamlet III

December 15 - Petard is a French word meaning firecracker. The English phrase To hoist on one’s own petard has come to mean To be harmed by one's own plan to harm someone else or To fall into one's own trap, literally implying that one could be lifted up (hoist, or blown upward) by one's own bomb.

The SGR is a Congressional bomb. It has been ticking since 1997 when Congress created it to rationalize physician Medicare payments based on the national inflation index, among other things.

Starting in 2002, the SGR has said physicians should be paid less than the previous year. For the last eight years, Congress has sought to detonate the bomb with a temporary “fix,” usually a small increase.

This year, however, doctors were slated to take a 25% “hit” in income. But today, in an act of quiet desperation, signed into law HR 4994, “Medicare and Medicaid Extenders Act of 2010,” a 1 % increase to “stabilize” doctor payments for one year beginning on January 1, 2011. Officials from the AMA, AARP, and the Military Association of America were present at the signing ceremony.

President Obama had no choice. Among AARP’s more than 40 million members, mostly seniors, 80% said they fared loss of access to doctors if SRG were not suspended or fixed. And 60% of doctors in various surveys, the most extensive of which was sponsored by the Physicians Foundation, indicated they would cut services or not accept new Medicare and/or Medicaid patients , if SGR went through as planned. On the AMA’s part, it faced further loss of physician members, now down to 15% or so of practicing physicians.

According to Lee Stillwell, former head of AMA lobbying in Washington, writing for The Physicians Foundation, in his Washington Report, “While no permanent fix appears on the horizon, the 12-month extension gives organized medicine and its allies time to devices a new game plan or gain a longer extension next year.” Until then Congress will remain hoisted on its own petard. That firecracker will go off precisely in one year if nothing is done.

Tweet: AARP and fear of seniors that doctors would pull out of Medicare forced Congress to increase rather than cut pay for doctors #PPACA