21 June 2010

Aw Crap

The World's Most Dysfunctional Legislative Body, the US Senate, finally managed to pass a "doc fix" last week -- a 2.2% update to the MPFS retroactive to June first, paid for by some offsets on hospital reimbursement. Their solution involved splitting it off from the more bitterly disputed jobs bill, which is much more expensive and difficult to pay for.  Great news, right?
Pelosi: 'No reason' to pass standalone doc fix
House Speaker Nancy Pelosi (D-Calif.) over the weekend put a damper on legislation preventing Medicare doctors from receiving a steep pay cut this month, arguing that the fix passed by the Senate Friday is "a great disappointment."
Not only is the five-month pay window "inadequate," Pelosi said, but separating the so-called "doc fix" provision from the tax extenders bill threatens the larger proposal.  
Aw crap.

I can see where Pelosi is coming from -- as a matter of tactics, she really wants the jobs bill to pass, and keeping high-priority items like the doc fix attached maintains pressure on Congress to move the whole package through. Split off the "must pass" elements and the other provisions wither on the vine.

So I get it, but, well, crap.


  1. Just out of curiosity, how much money did you personally lose as they start to process the last two weeks worth of payments at the lower -21% rate?

  2. Umm, I call pure partisan BS on you here.

    Had this been a Rep Speaker holding healthcare hostage, you'd be on your high horse denouncing them in the worst possible terms.

    Now Your Speaker does the unconscionable, and "So I get it, but crap" is what you've got?

    So, your credibility is on the line; either holding healthcare hostage is abominable and wrong, or it's not. You don't get to have it both ways when your Speaker is the one handing all docs a pay cut. Which you know will directly affect patients.

    Oh, and here's for you desired Single Payor system: these morons, on both sides of the aisle, will be doing this forever.

    So, square the circle, call out your friends like you do your opponents, or admit the hackery.

  3. Dear Grunt Doc,

    Hi, are you new here? Perhaps you have missed the multiple times in which I have written about single payer and its flaws and drawbacks. I think I made pretty clear that I am not a single payer advocate. I await your apology.

    As for Pelosi, she is one player among many in this fiasco, and not the most culpable. What about the hypocritical GOP senators who blocked the SGR fix over and over again because it was deficit financed (never had a problem with deficit financing when they were in charge). I'm not partisan either: dickhead Ben Nelson and loathsome cockroach Joe Lieberman are equally to blame (for valuing contrarianism above the public good), as are moderates like Collins and Snowe (for valuing party loyalty above their actual ideologic values). So while this post focused on Pelosi's recent roadblock, to an SGR fix, I do not think she is the worst player in this epic tragedy/farce.

    And I am also willing to concede that maybe (just maybe) she is right. Maybe the extension of unemployment benefits in a time of historic unemployment *is* a policy priority worth fighting for. I hate being the rock the lever is placed on, but levers have a history of getting the job done. I'm not going to get into a policy debate over the jobs bill because it's not at all my area of wonk-fu. But I am not going to discount the possibility that she is making the right tactical decision.

  4. Sophistry, Dr. Fax.

    Gruntdoc is right, at least from where I'm sitting. If this had been a Newt Gingrich or a Dennis Hastert type, you'd be wailing and smearing your face with ash, accompanied by much gnashing of the teeth.

  5. I love all the people who like to project their imagined "Shadowfax insane hyper-partisan reaction" onto me without bothering to examine the, you know, actual record. So you think that I went easy on Pelosi the Democrat when I would have gone ballistic on a Republican who had the temerity to obstruct the SGR patch? Seems plausible. Except it happened -- quite recently, when Bunning played a similar game. What did I say then?

    "So it's a futile, meaningless gesture [...] But it's a great example of the many ways that the Senate is deeply dysfunctional [...] it's a great example of why reform wouldn't necessarily be a bad thing."

    Hmm. A kind of wonky musing on filibuster reform. Not EXACTLY ashes and sackcloth territory, is it? Which is not to say that I am never partisan; quite the opposite. I'm less intense these days now that Bush is gone, and less prone to going ballistic perhaps. But I don't think the record supports much of a double standard on this point.


Note: Only a member of this blog may post a comment.