Friday, March 27, 2015

The Doc Fix is On - Reading Between the Partisan Lines

Lawmakers closed in on passage of a measure to permanently replace an 18-year old formula for reimbursing doctors for Medicare patients, as support in the House swelled and resistance faded among Senate Democrats.

Siobhan Hughes, “Passage of ‘Doc Fix’ Edges Closer, Wall Street Journal, March 26, 2015

The two political parties, 18 years after the 1997 Sustainable Growth Formula (SGF) was enacted, tying doctor incomes to the Gross National Product, and 17 years of annual patches, have decided to discontinue the SGF.

Why the shift to a bipartisan solution?

I suspect there are multiple reasons.

Among these are:

National surveys of doctors indicating that 62% of doctors planned to retire early and 56% said they planned to see fewer Medicare patients. Given current doctor shortages of 50,000 to 100,000 among primary care practitioners and specialists, this is unacceptable to voters, who tend to trust doctors more than government and who are reluctant to accept physician assistants, nurse practitioners, and other physician replacements as go-betweens.

Government promises that the Americans could keep their doctors, hospitals, and health plans, when these promises, coupled with narrowing of networks and cancelled health plans , were proven to be untrue, and were known when ObamaCare was enacted.

Consumer and physician disenchantment with health exchange, Medicare, and Medicaid plans. One of four doctors have said they do not plan to accept members of such plans, and further more, somewhere between 10% to 40% of doctors, depending on region of the country, have said they will not longer accept new patients on government sponsored or subsidized plans.

A growing consumer and physician movement away from government or insurer plans towards cash-only care outlets such as retail clinics, urgent care clinics, work site clinics, ambulatory surgical units, and concierge physicians.

A compromise between Democrats, who are getting what they want, health insurance for children in low-income families and to shifting costs to higher income Medicare patients and Republicans who seem to be willing to accept higher deficits in a package that would cost $214 billion over a decade and add $141 billion to the deficit without corresponding tax increases.

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