26 June 2008

Breaking: Republicans Filibuster Medicare Fix

From The Hill:

The Senate left town Thursday night for a week and a half after passing billions in domestic spending initiatives and a new GI Bill but falling a single vote short of passing Medicare legislation that would have prevented pay cuts to physicians. [...] The Medicare legislation would have blocked a 10.6 percent fee cut to physicians that is scheduled to take effect on July 1. It failed 58-40, two shy of the required 60, but Majority Leader Harry Reid (D-Nev.) switched his vote to “no” as a procedural move that allows him to bring the bill back up for a future vote. Sens. Edward Kennedy (D-Mass.) and GOP presidential candidate John McCain (R-Ariz.) missed the vote.
Fun fact: McCain has not shown up to the Senate to cast a vote since April. His would have been the deciding vote.

Republicans oppose the temporary SGR fix because funds to pay for it were obtained by reducing the size of the Medicare Advantage plans.

The net effect here is that as of next week, physicians can expect to see that 10.6% cut in compensation from all their Medicare patients. Perhaps there will be a stop-gap fix while a compromise is worked out, or perhaps, as in 2006, the ultimate solution will be retroactive to July 1. The conventional wisdom is that the cuts will eventually be stayed, but once they are implemented, and become the status quo, the higher the likelihood that the remedy will not appear and we will be stuck with the lower rates, or that a fix, if it comes, may be less than initially expected.


  1. I started a surgical practice in the south out of training 3 years ago. I now find myself caring for a typical mix of patients: 50% medicare, 20% indigent (no-pay, and 25% private insured. These cuts are going to hurt, I already work 12-15 hour days and have to limit myself to no more than 50% medicare patients to keep my practice financialy viable. I can't honestly do more and still provide quality care. These cuts have helped me with a decision I've given much thought to recently. I have decided no longer take medicare assignment.I surely won't be quite as busy, and I'll likely have to lay off some of my office staff, but I'll be able to keep the practice open and maybe I'll get home occassionaly to have dinner with my family.

  2. Well, Shadowfax, I guess it's up to me to point out that this is just a prelude to what you're going to get if your brand of government-run health care is enacted.

    You can whine about the Pubbies all you like, but this isn't really about them (or any other "progressive" bogeyman). It's about inept central control of a large medical program.


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