Comments on: Harry’s Other Headache, The $245 Billion Medicare Payment Fix To Buy Off The AMA – UPDATED

By: wesgpc

wesgpc — Sun, 18 Oct 2009 02:14:35 +0000

That kind of ridiculous decision making you mention is the reason why the current system has to be reformed. I agree that trying to force the current Medicare payment systems into the public option with no modification is going to cause hardship for some providers and some regions. I think the whole topic is being avoided for now in order to keep major interest group players like the AMA from outright opposition to any reform at all.

By: brchandler

brchandler — Sun, 18 Oct 2009 00:11:02 +0000

As an an anesthesiologist, in favor of the public option for the greater good, I must note that when medicare instituted its payment structure, based on a research study, the study did not include anesthesia services. So, in the early 90′s, when relative value adjustments were made based on the study, and somebody asked, “What about Anesthesia?”, the answer was “What’s left?”. While most specialities were cut 25 – 30 % of the amount billed, Anesthesia was cut 66%–what was left over.
Therefore you can understand the trepidation of the Anesthesia community when the public option wishes to extend medicare rates to a larger pool. I cannot speak for other specialities.

By: bmull

bmull — Sat, 17 Oct 2009 02:43:37 +0000

It is disgusting that the physicians are able to get their fix ahead of health reform, without any guarantee that they will support real reform in return.

The price for the fix should be supporting a Medicare+5% public option, nothing less.

By: joanneleon

joanneleon — Sat, 17 Oct 2009 00:33:03 +0000

On one hand, 14,000 people lose their health insurance every day. 45,000 people die every year because they can’t afford health care. What does the Senate do? Stall, delay. Just be patient, Americans. And by the way, these reforms won’t be available to you for another three years (minimum) anyway, so what’s the hurry?

Doctors are going to take a cut in their reimbursement rates. What does the Senate do? Rush that baby through the Congress so that the rate cut never happens and the doctors never lose a dime.

This is how our Congress represents us.

By: joanneleon

joanneleon — Sat, 17 Oct 2009 00:20:26 +0000

It’s amazing how quickly Reid can work to get something passed, and how skillfully he can get the votes, when it benefits the establishment or the major corporations. When it’s something for the people? It’s always too hard to “get the votes” or some other pitiful excuse.

By: OldFatGuy

OldFatGuy — Fri, 16 Oct 2009 21:53:21 +0000

LOL, yeah mine too.

I just couldn’t figure out whether those names voted FOR the war or AGAINST the war. And it’s 23 names, not 22.

So I be cornfused.

I mean seeing Paul Wellstone and Russ Feingold on that list makes me think these were the ones that voted AGAINST the war. So Conrad voted against the war?

By: MarkH

MarkH — Fri, 16 Oct 2009 21:35:04 +0000

Gov’t put into place healthcare price restraint and the industry just ignored them. Surprise surprise.

Now the cuts have piled up or the healthcare prices have skyrocketed and the ‘patch’ would be rather large. So, all of a sudden they want to be fiscally responsible.

What it really shows is that gov’t can be bought and the real restraint to healthcare prices is competition.

Public Option NOW!

By: Leen

Leen — Fri, 16 Oct 2009 20:55:01 +0000

Bayh is the one who makes my head hurt

By: Frugalchariot

Frugalchariot — Fri, 16 Oct 2009 20:33:22 +0000

“Reagan proved that deficits don’t matter.” (Dick Cheney)

I have a great idea: Cut “Defense” budgets by, say, 75%, or whatever it reasonably takes to reduce to a defense only budget. No more aggressive war, no more interference, none of that crap. Then write a new law that says all wars other than strictly defensive retaliation will be financed solely and completely by tax hikes on anyone that makes more than, say, $250,000. And if need be, every penny above that baseline $250,000 can be confiscated to pay for war. If that’s not enough, then take some more. After they attain “middle class” status, reevaluate. Give them a break on their health care premium, maybe.

Yep, I’m as sick of war as I am sick of the ever-richer fuckers that milk the same old cow year after year. Halliburton, KBR, Blackwater, et al. et al. anyone?. Been watching one or another episode of the same stupid crap all my life. My first three years (Oct. 1942-Sept. 1945) were legit defensive war. Nothing since then has even come close. How goddamned stupid can an “enlightened” people such as ourselves be?

By: wesgpc

wesgpc — Fri, 16 Oct 2009 20:23:35 +0000

There is an interesting post on the Seminal Reader Wire that gives a glimpse into the process that determines how medical procedures and physician tasks are classified and reimbursement set. Anyone interested in how it works should take a look.

My only comment is that I do not think that it is an intentionally corrupt system. This approach to physician reimbursement began as a way to control individual doctors and payers from gaming the previous system of ‘usual and customary fees’ when medicine got so complex and sarted changing to rapidly that it no longer worked well. The problem is that this fix to a previous system has been captured by the AMA and is now a very serious source of a conflict of interest for the AMA. It has ossified into a inflexible proprietary system almost completely controlled by the AMA. They have copyrights on most of it. Not only the public, but individual doctors complain that they have trouble getting enough information about it.

Mad as Hell Docter Paul Tells About Crashing the White House and a secretive AMA Committee
By: montanamaven Thursday October 15, 2009 5:08 pm

http://seminal.firedoglake.com/diary/9748