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Health Overhaul Train Leaves Doctors On The Platform

If you’re a doctor who treats Medicare patients, there’s good news and bad news today.

The good news: President Obama today signed legislation rescinding the 21 percent pay cut that took effect June 1 (retroactively) and you’re getting a 2.2 percent raise.

The bad news: It all expires again at the end of November.

Doctors are not exactly thrilled with the turn of events, perhaps given the fact that this is the third time this year Congress has had to vote to avert the cut, and the second time it’s had to do so retroactively.

“Delaying the problem is not a solution,” said Cecil Wilson, the newly elected president of the American Medical Association. “It doesn’t solve the Medicare mess Congress has created with a long series of short-term Medicare patches over the last decade – including four to avert the 2010 cut alone.” (The first one came last December.)

But some people wonder if the AMA didn’t contribute to its own problem, by not making sure that the Medicare doctor pay problem was fixed during the health overhaul process.

“During health care reform, that was the point of maximum leverage for the forseeable future,” said Alec Vachon, a health policy consultant. “The AMA had the biggest opportunity, because there was nothing more that the White House wanted more than the endorsement of all the key groups that represented health care interests.”

Yet while hospitals, nurses, drugmakers, and others all got what they wanted in the bill before they endorsed it, doctors did not.

That, says Vachon, was their key mistake. “That should have been their demand from day one,” he says. “‘We’re not going to be supportive of this process unless we can be sure that our members can take care of Medicare patients.’ Because right now all that’s in jeopardy because of this broken update system.”

Now, he says, with Congress having moved on to other things, the doctors have “lost their leverage.”

AMA President Wilson, however, says blame for the Medicare mess only belongs in one place, and that’s with Congress.

After lawmakers overrode President George W. Bush’s veto to cancel a 10 percent Medicare cut in 2008, Wilson says, “they said we will resolve this problem. So this is a problem that predates health system reform.”

And the fact that the problem not only persists, but has gotten worse two years later?

“The failure here is a failure of Congress to act responsibly,” he said. “It is in Congress’s lap. Now we can urge them to do this and we will continue to apply pressure, but the responsibility to do this is Congress.”

Lawmakers have now given themselves until November 30 to come up with a solution.

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