Small Businesses, Doctors Oppose Some Health Overhaul Proposals
Small business and medical groups are debating the health care overhaul proposals that could change their business models.
"A proposed income-tax surcharge on high-income Americans to help fund an overhaul of the health-care system could hit one-third of small businesses, according to the National Federation of Independent Business," The Denver Business Journal reports. The surcharge, which has been approved by the House Ways and Means Committee, would add a 1 percent to 5.4 percent surcharge on individuals with incomes of more than $280,000 and households earning more than $350,000.
"... House Democratic leaders countered that it would not apply to 96 percent of small businesses. The Center on Budget and Policy Priorities says the 4 percent of small businesses affected by the surcharge includes 'partners in large law and accounting firms, and investors who have stakes in Wall Street investment partnerships.' Overall, about 600,000 individuals with small-business income could be hit with the surchargeNFIB estimates one-third of companies with 20 to 250 employees could face the surcharge, based on a survey of small-business owners in December 2007." (Hoover, 7/27).
Meanwhile, Congress Daily reports on "one little-discussed proposal to create progressive, coordinated networks of healthcare providers. ... Under a pilot program proposed in the House's version of healthcare reform legislation, 'medical home' providers would be empowered to shepherd patients through stages of treatment, assembling a coordinated team of medical professionals and ensuring that different practitioners do not duplicate each others' work. The House proposal would encourage providers to participate by offering bonus Medicaid reimbursement payments for the extra phone calls, visits and other work required to organize the team treating each patient."
"But even as it won accolades from providers, academics and business groups, Congress' inclusion of the new program in its overall reform effort set off a dispute about exactly who should be eligible to participate. In addition to physicians and their assistants, the bill in its current form authorizes nurse practitioners to serve as the heads of medical homes if state law allows it. ... Groups like the American Nurses Association and the American Academy of Nurse Practitioners argue that nurse practitioners offer many of the same basic services as physicians at lower cost. But physicians' groups fret that nurse practitioners, who require less education than that required for an M.D., could endanger patients if given too much leeway to diagnose problems and make referrals" (Dann, 7/27).