A new threat to the heath reform

Harry Reid

Only a few days ago healthcare insurers united against the healthcare reform, so it's been expected that more opposition may come out of the woodwork. As such, the Democrats have started to worry what other key industry players might drop their support of the reform.

In what seems like a precautionary measure, Senate majority leader Harry Reid invited the American Medical Association (AMA) and 10 other doctors' groups in for a meeting, according to Time magazine.

The result of this meeting was a stand-alone, unfunded bill on the Senate floor, which would hand doctors $247 billion more than they would otherwise get for their Medicare services over the next 10 years.

Senate Finance Committee chairman Max Baucus, one of the key men drafting a final Senate bill behind closed doors this week, on Tuesday called the doctors' legislation "very important" to ensuring final passage of healthcare reform.

Opposition

Republicans counter that that is precisely the problem. Not only is the move a obvious ploy to get physicians onboard the reform bill, said Senator Jon Kyl, the No. 2 Senate Republican, "I also see it as a transparent way to take the deficit off the table."

Republicans have called the move a budget trick, one of many Democrats are using, they say, to help keep down the final price tag of the reform bill; they insist it actually costs more than $1.2 trillion over 10 years instead of the less than $900 billion the Congressional Budget Office estimates the Baucus version of the bill will cost, all of it offset by cuts to avoid adding to the deficit.

What happened?

Observers say that neither side is correct. The issue with Medicare reimbursements goes all the way back to 1997, when then-president Bill Clinton and a Republican Congress altered the formula which dictates Medicare payments.

At the time, the so-called sustainability growth rate (SGR) was depegged from inflation to wage growth.

It was fine with doctors until the recession hit and wage growth ground to an abrupt halt, posing the threat of real cuts to their Medicare reimbursements. To stop that from happening to a constituency no politician likes to alienate - or, worse, having doctors cut services to patients - Congress passed a one-year spending patch to fix the problem in 2003.

Six fixes later, that "temporary" solution has become an annual, bipartisan affair that hasn't solved the problem. So now, unless Congress acts, doctors are looking at a wage cut of 21 percent next year and 40 percent the year after.

But the $247 billion would simply freeze doctors wages for 10 years, basically giving Congress breathing room to fix the problem.

There's still no guarantee the AMA or other physicians' groups will support the healthcare reform in the end.

"We haven't seen the Senate bill," AMA president Dr. J. James Rohack said at a press conference Tuesday urging passage of the 10-year freeze.

"So once we get that out there then I'll be able to answer that question."

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