Doctor Shortage - Medicare Pay Cuts for Doctors: The Saga Continues

Prelude: To doctors the SGR formula is a symbol of their political impotence. The following is from the Wall Street Health Care Blog.

By Jacob Goldstein

“A bill introduced in the Senate this week would block the 21% Medicare pay cut for doctors scheduled to take effect for doctors next year. Blocking the cut would increase the government’s costs by more than $200 billion over the course of a decade.”

“Loyal Health Blog readers know all too much about the sustainable growth rate, the mechanism Congress adopted in the 1990s to try to ensure that the amount the Medicare pays for annual doctor care of each beneficiary doesn’t grow faster than the overall economy.”

“Obviously, it didn’t work. Doctor costs per beneficiary have shot up along with the rest of health care spending. Under SGR, when overall spending on doctor care increases in this way, the amount doctors get paid for each service is supposed to go down. But Congress has intervened time and again to block cuts that were supposed to take effect under SGR.”

“The health-overhaul bill introduced in the House would scrap the existing SGR formula. The Senate Finance bill blocks the pay cuts for next year but leaves SGR in place, which means the pay cut would be back in 2011. “

“So this week Sen. Debbie Stabenow, a Michigan Dem, introduced a bill in the Senate (S.1776) to get rid of the existing SGR formula. Because of some procedural hocus pocus, it may go straight to the Senate floor without going through a committee.”
“The AMA, which supported the House health bill, said today it’s launching TV ads to support the Stabenow bill.”

“Meanwhile, Dow Jones Newswires reports, Senate Minority Leader Mitch McConnell said today that Republicans will offer amendments to offset the cost of the bill. He argued that the bill was introduced separately from the Senate Finance committee’s big health-care bill as an accounting trick, to keep the costs of the broader bill below $900 billion.”

And so the saga for cutting doctors’ annual Medicare pay goes on. In the House, the SRG is to be forgotten, in the Senate it is not gone. The House would eliminate the failed SRG formula completely, The Senate would drop it for a year, then reinstate it discretely. To Congress it appears doctors are nothing but a financial pawn.
Still Congress fears a widespread doctor shortage. This could lead to political short circuit, even a genuine electoral outage. Doctors deserting Medicare due to low pay hangs like the sword of Damocles. Legislators fear loss of medical expertise, perhaps even a physician stoppage.