Monday, May 4, 2009

A Side Deal on the Medicare Physician Fee Cuts? What Does That Say About the Chances for Health Care Reform?

John Reichard has dug deeper than anyone else into the Medicare physician payment problem in an important article in today's CQ HealthBeat.

He reports that the Blue Dog Dems (about 50 House moderate and conservative deficit hawks) may be willing to give the docs a pass by not requiring offsets for a two-year patch for their upcoming fee cuts--including the 21% fee cut due on January 1st. They are also reportedly willing to give the same pass for a three year alternative minimum tax (AMT) fix that would otherwise hit the middle-class hard.

A two-year "patch" for the Medicare physicians would cost $38 billion.

Reichard reports that the Blue Dogs' price is a statutory pay-go requirement--legislation that would require spending cuts or new revenue on any other legislation that would add to federal spending. He also reports that, "House Democratic leaders insist they'll back up the Blue Dogs on statutory pay-go and that if it isn't passed will demand offsets for the doctor fix..."

Which all begs a question: If these same Democratic leaders are so confident we will get health care reform this year, why are they doing a deal for a two-year doctor patch?

As I have been reporting here for months, health care reform is stuck in the mud over how to find the money to pay for it.

That Democratic leaders in the House are willing to find a two-year patch for the Medicare docs just reenforces the notion health care reform--and physician payment reform for that matter--is floundering for a lack of a clear course to do either.


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