Physician pay-- a sideline
to the health care
reform debate

Senators to Vote on Whether to Stop Medicare Funding Cuts to Doctors

October 19, 2009
by Brendon Nafziger, DOTmed News Associate Editor
Senators are expected to vote on a bill stopping Medicare funding cuts to physicians. Following Monday's vote postponement, Senators are expected to decide on Tuesday afternoon whether to end debate on S.1776, the Medicare Physicians Fairness Act. The cloture vote would be the first of three votes likely needed before the bill would pass.

Introduced last Tuesday by Debbie Stabenow (D-MI), the act aims to repeal the oft-ignored sustainable growth rate (SGR) formula that's supposed to help calculate Medicare physician payments and keep them in line with the rest of the economy, as required by the Balanced Budget Act of 1997. However, except for in 2002, proposed cuts to physician fees demanded by the SGR were nixed by Congressional intervention every year.

According to The Hill, the Congressional Budget Office estimates that the bill will cost $246.9 billion over the next 10 years, but if not passed, would result in around a 20 percent pay rate cut for physicians next year.

Some think that the bill is just making explicit what taxpayers will have to heft anyway, as Congress already scuttles the SGR's proposed pay cuts.

"Do we address the issues associated with the cost of providing health care, or are we going to go into this annual deferral...to assess what these costs are going to be?" asks Robert W. Atcher, Ph.D., former president of the Society of Nuclear Medicine, in an interview with DOTmed News.

But the bill faces some hurdles, as centrist Democrats are lukewarm to it, and many Republicans actively oppose it, seeing the bill as an attempt to hide the true costs of health care reform. The Senate health care reform bill is currently expected to hit its budget cap of $900 billion but, unlike the House bill, doesn't take into account the expected cost of paying doctors the additional $247 billion over the next decade -- a cost that many believe will eat deeper into the federal deficit.

Such is the opinion of Dennis Smith, a senior fellow at the American Heritage Foundation, a conservative think tank, who tells DOTmed News that the proposed bill is a "budget gimmick," and that "all the promises of fiscal discipline are out the window."

"Doing the doctor fix will only help to guarantee the cost of health care will keep rising more rapidly than the rest of the economy," he says. "This is a flashing neon sign saying, 'Forget all the talk about lowering the cost of health care. We just aren't going to do it.'"

But Dr. Atcher believes these costs are, in some ways, unavoidable. "The median age of the population is getting to the point where the need for health care is going to increase," he says. "The natural increase in utilization of health care is just based on the changing demographic of those who live in the United States."