08 December 2006

Why are we ruled by these miscreants?

I apologize for my extended absence -- I think I went on blogging overload after the election, and frankly, have had writer's block the last couple of weeks. Also, I have not been working clinically too much, which limits the "bizarro" stuff I get to see and write about.

But it was with a thrill of excitement that I got an email last night telling me that

"House and Senate negotiators just reached a compromise bill that would eliminate a scheduled 5% Medicare rate cut for physicians in 2007 and establish a 1.5% incentive increase for doctors who report on quality measures."
Wow! Great news! This scheduled rate cute (the first of an estimated 30% cut in physician reimbursement) has been hanging over our heads and causing great anxiety in the medical community. So I was thrilled to see that it looks like it would be canceled.

Then today I read this Washington Post summary. The bill, if it passes some serious obstacles, would also:
  • Allow unlimited tax-free deposits in HSA (creating a billion-dollar tax loophole for the wealthy)
  • Cut health care for low-income children
  • Open 8 million acres of the Gulf for oil exploration
  • Allows oil companies to continue extraction in the Gulf without paying royalties
  • Give business $7.5 Billion in tax breaks for R&D
  • Allow clothing importation from Haiti without tariffs
Among many, many other unrelated line item tax breaks and carve-outs, some reasonable and many heinous. Why are all these unrelated items in one bill? Why is this bill the very last thing Congress is acting on before adjourning? Why, every year, is the freeze on physician reimbursement cuts linked to some unholy compromise.

I wish I could say with confidence that things would be different or better under the incoming Democratic Congress. I suspect that the objectionable content of these smorgasbord bills will be lessened. On the other hand, I suspect (wrongly, I hope) that the Democrats may be less friendly to a freeze on the Medicare cuts, which will already have gone into effect. At any rate, it certainly won't be one of their legislative priorities.


And over at The Health Care Blog, they complain that "the AMA still has Congress where it wants it." Weird.


  1. Welcome back. I enjoy your posts. Writer's block sucks.

  2. And what is so wrong with more domestic oil exploration? And tax break for HSA's? The wealthy already pay most of the taxes. We need more of them, wealthy people that is.


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