Friday, October 16, 2009

More Smoke and Mirrors on Healthcare Reform

There is a current bill in the U.S. Senate, SB 1776, that is being touted as an "18 line bill" that would solve Medicare problems by repealing the Sustainable Growth Rate (SGR). This is being touted by the AMA and state medical associations as a good thing. Unfortunately, it's another game of smoke and mirrors in Washington with the AMA playing along.

What's the SGR?

The bill repeals the Sustainable Growth Rate (SGR) freezes physician payments from Medicare for the next ten years. The SGR is a flawed law that was passed by Congress many years ago to fool the taxpayers into thinking that Medicare funding isn't as bad as it really is--that is, so these fat cats can get reelected. By mandating cuts in physician reimbursement every year, on paper it looks like they are saving money.

On the other hand, these elected criminals vote every year to cancel out the reduction, leaving the payments the same. However, by the law, this decreases each year. This snowballs, such that this year it was scheduled to decrease 21%. Basically, this allows our congressional representatives to vote to prevent the cut so they look good. Yet, they still have this big accounting flaw right there. If you and I did that on our taxes, we'd be in prison.

Isn't the American Medical Association (AMA) the Voice of Doctors?

Most people don't realize it, but the AMA represents less than 20% of physicians nationwide and most of the membership is medical students and residents--that is, a significant amount of them aren't what we would call 'real doctors' yet. We don't know the number for sure, because the AMA won't release the information to the public, but it's estimated that they make up at least 1/3 of the membership.

These doctors in training join the AMA because they're told that the AMA represents physicians in America (and because they get discounted membership rates). That certainly isn't the case today, yet the mainstream media acts as if like the AMA in a unified voice for doctors.

When the media reports that the AMA is backing something, they spin it to imply that almost all physicians are backing it. Nothing could be further from the truth. When I was in medical school, the AMA faced a backlash when it tried to make money by selling it's logo for product placement on silly and unrelated things like kitchen appliances.

Earlier in the year, the AMA pledged its support for President
Obama's healthcare reform in return for a permanent SGR fix. For an organization that is supposed to have the best interests of physicians at heart, this was an utterly idiotic political move. This resulted in alienating many physicians that still were in the AMA. Several thousand more doctors left the AMA this spring after this fiasco.

The Real Reason Behind S1776

From what I have heard from my senators offices is that this bill was offered by
the democratic leadership to buy off the AMA--so that they would stop
pushing for medical malpractice reform.

Medical malpractice reform is probably the number one thing we could do to control healthcare costs. Our current healthcare crisis is largely due to increasing medical costs because of:
1. There are more older people on Medicare now than younger employed people paying into the system.
2. US doctors are forced to order many unnecessary, expensive and potentially harmful tests because of the out of control medical malpractice industry in our country. This is referred to as defensive medicine. As a radiologist I see defensive medicine being practiced on an hourly basis.

In conclusion, SB 1776, with it's patriotic looking bill number will be touted as a quick fix for Medicare physician reimbursement by the media over the next week. However, like most bills originating in Washington DC, it's a bunch of smoke and mirrors hiding yet another empty gesture.

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