Re: Medicare Pricing Frozen As Congress Leaves Town

[Guest guest]

This whole debacle is not surprising; in fact, I would argue that it's not even

news.

Year after year, a looming Medicare cut is somehow stiff-armed, and year after

year, the anemic and inadequate Medicare reimbursement system loses pace with

the real world of increasing overhead expenses and patient numbers.

At the risk of contributing to what is become cliche, watching Congress

fiddle-f#rt with reimbursement of our nation's most influential market

determinant in the aging population, is worthy only of a Saturday Night Live

skit or Jon parody.

I struggled with opting-out, since I feel an obligation to the many older

patients who would have followed me in my IMP two years ago. But I felt that it

was too much of a liability for me to invest the time and energy to align myself

with a system that demonstrated no hope in improving its reimbursement formula

or its approach to fair reimbursements to primary care in general.

I concede this has impacted my income in this rural, and largely elderly, area.

But at least I can watch the debacle from the outside now and just shake my head

at the incessant shenanigans.

Charlie Vargas

lin, NC

perpetualhealth.org

Date: 2008/06/27 Fri PM 09:22:52 CDT

To: Locke's in Colorado

Subject: Medicare Pricing Frozen As Congress Leaves Town

Medicare Pricing Frozen As Congress Leaves TownUpon Thaw, Program's Payments to

Doctors May Be Cut Almost 11 PercentBy KaneWashington Post Staff Writer

Saturday, June 28, 2008; Page A03

With congressional leaders engaged in heated brinkmanship, the Bush

administration yesterday gave a reprieve to thousands of doctors expecting to

get hit Tuesday with a 10.6 percent cut in Medicare payments.

The Department of Health and Human Services will essentially freeze the current

pricing system because Congress left town yesterday for a midsummer break

without approving a price fix, Secretary Mike Leavitt announced. Congressional

aides said the freeze could last 10 days.

If the legislative dispute lasts beyond the new deadline, Leavitt said he hopes

to retroactively pay doctors once the dispute is resolved.

But there was no sign of cooling off on Capitol Hill. Yesterday, each side

accused the other of playing politics with Medicare, the program that covers

many health-care costs for the nation's elderly.

Feelings were particularly raw after a Thursday night Senate vote in which

members yelled at one another on the floor and left Democrats one vote short of

the 60 needed to pass their version of the Medicare fix.

" That display last night on the floor is something I've never seen, " said Sen.

Arlen Specter (R-Pa.).

The roll call vote was held open for an additional 25 minutes so Sens. Barack

Obama (D-Ill.) and Hillary Rodham Clinton (D-N.Y.) could make it to the chamber

from their fundraiser at the Mayflower Hotel. Sen. Jim Bunning (R-Ky.) grew

irritated about waiting for Clinton, the last to arrive, and called for " regular

order " to shut down the vote. That led to a shouting match with Sen. C.

Byrd (D-W.Va.), who yelled " Who are you? " and mockingly called his colleague a

" great baseball man. "

Bunning, a Hall of Fame pitcher in the 1950s and 1960s, shouted back that he has

the same rights on the floor as Byrd, the longest-serving senator in history and

the chamber's leading parliamentary expert. The exchange ended with Byrd loudly

laughing.

The payment cuts to doctors are part of a 1997 balanced budget deal that trims

the money going to Medicare, but the doctors have regularly staved off the cuts.

They argue -- through their lobby, the American Medical Association, and the

AARP -- that slashed payments would prompt many doctors to drop out of the

system. Private insurance companies make a similar argument for Medicare

Advantage, a program of private fee-for-service insurers and HMOs, that is

targeted in the Democrats' bill.

By reducing funding for Medicare Advantage, the Democrats would pay for

postponing the pay cut to doctors for 18 months. The legislation could result in

$14 billion less for insurers over five years, though an estimate by a

conservative House Republican caucus put the tally at $47.5 billion over 11

years.

The White House has threatened a veto over Medicare Advantage cuts, arguing that

the Senate Finance Committee is close to working out a compromise without

cutting payments to private insurers in that program.

Those negotiations, between Sens. Max Baucus (D-Mont.), the finance committee

chairman, and E. Grassley (R-Iowa), broke down when Senate Majority

Leader Harry M. Reid (D-Nev.) decided to push ahead with the House bill after it

passed that body Tuesday by a veto-proof margin.

Aides said yesterday that no new talks had begun, and after the Senate

reconvenes July 7, it will have three days to pass a fix before the HHS freeze

is lifted.

At one point during Thursday's debate, Reid literally hopped around the chamber,

predicting Democrats would hold " at least " 59 Senate seats next year because

Republicans toed Bush's line.

" I don't know how many people are up here for reelection, but I am watching a

few of them pretty closely, " Reid said, staring at the GOP side of the chamber.

" I say to all those people who are up for reelection: If you think you can go

home and say, I voted no because this weak president, the weakest political

standing since they have done polling, I voted because I was afraid to override

his veto -- come on. "

Minority Leader Mitch McConnell (R-Ky.), visibly angered by Reid's speech,

offered temporary legislation that would forestall the pay cuts to doctors

through July, but Democrats objected. Yesterday Jim Manley, Reid's spokesman,

mocked Leavitt's 10-day delay " as nothing more than a fig leaf " to offer

political cover to Republicans.

[Guest guest]

Physicians are afraid of change. They avoid conflict at all costs. So only by individual actions are we going to get anywhere. I also believe (am I wrong?) that the patients truly do care about us getting paid, they would like the system to change, but they, too, are afraid of conflict. They are also afraid of losing their insurance, and so they will not join us in this revolution. They will go to the big DOc-in-a-Box rather than stand with us and fight.

Once the big groups realize they are getting "stuck" (can't think of a better word...) with the insurance game and we are getting paid properly, only then will they also fight for change. Maybe. The more of us who fight back, the better protected we will be.

I am dropping 2 more payers in the next week or two. I feel great!

Subject: Re: Medicare Pricing Frozen As Congress Leaves TownTo: Date: Saturday, June 28, 2008, 4:39 AM

This whole debacle is not surprising; in fact, I would argue that it's not even news.Year after year, a looming Medicare cut is somehow stiff-armed, and year after year, the anemic and inadequate Medicare reimbursement system loses pace with the real world of increasing overhead expenses and patient numbers.At the risk of contributing to what is become cliche, watching Congress fiddle-f#rt with reimbursement of our nation's most influential market determinant in the aging population, is worthy only of a Saturday Night Live skit or Jon parody.I struggled with opting-out, since I feel an obligation to the many older patients who would have followed me in my IMP two years ago. But I felt that it was too much of a liability for me to invest the time and energy to align myself with a system that demonstrated no hope in improving its reimbursement formula or its approach to fair reimbursements to primary care in

general.I concede this has impacted my income in this rural, and largely elderly, area. But at least I can watch the debacle from the outside now and just shake my head at the incessant shenanigans.Charlie Vargaslin, NCperpetualhealth. orgFrom: Locke's in Colorado <lockekcomcast (DOT) net>Date: 2008/06/27 Fri PM 09:22:52 CDTTo: Locke's in Colorado <lockekcomcast (DOT) net>Subject: [Practiceimprovemen t1] Medicare Pricing Frozen As Congress Leaves TownMedicare Pricing Frozen As Congress Leaves TownUpon Thaw, Program's Payments to Doctors May Be Cut Almost 11 PercentBy KaneWashington Post Staff Writer Saturday, June 28, 2008; Page A03 With congressional leaders engaged in heated brinkmanship, the Bush administration yesterday gave a reprieve

to thousands of doctors expecting to get hit Tuesday with a 10.6 percent cut in Medicare payments. The Department of Health and Human Services will essentially freeze the current pricing system because Congress left town yesterday for a midsummer break without approving a price fix, Secretary Mike Leavitt announced. Congressional aides said the freeze could last 10 days. If the legislative dispute lasts beyond the new deadline, Leavitt said he hopes to retroactively pay doctors once the dispute is resolved. But there was no sign of cooling off on Capitol Hill. Yesterday, each side accused the other of playing politics with Medicare, the program that covers many health-care costs for the nation's elderly. Feelings were particularly raw after a Thursday night Senate vote in which members yelled at one another on the floor and left Democrats one vote short of the 60 needed to pass their version of the Medicare fix. "That display last

night on the floor is something I've never seen," said Sen. Arlen Specter (R-Pa.). The roll call vote was held open for an additional 25 minutes so Sens. Barack Obama (D-Ill.) and Hillary Rodham Clinton (D-N.Y.) could make it to the chamber from their fundraiser at the Mayflower Hotel. Sen. Jim Bunning (R-Ky.) grew irritated about waiting for Clinton, the last to arrive, and called for "regular order" to shut down the vote. That led to a shouting match with Sen. C. Byrd (D-W.Va.), who yelled "Who are you?" and mockingly called his colleague a "great baseball man." Bunning, a Hall of Fame pitcher in the 1950s and 1960s, shouted back that he has the same rights on the floor as Byrd, the longest-serving senator in history and the chamber's leading parliamentary expert. The exchange ended with Byrd loudly laughing. The payment cuts to doctors are part of a 1997 balanced budget deal that trims the money going to Medicare, but the doctors

have regularly staved off the cuts. They argue -- through their lobby, the American Medical Association, and the AARP -- that slashed payments would prompt many doctors to drop out of the system. Private insurance companies make a similar argument for Medicare Advantage, a program of private fee-for-service insurers and HMOs, that is targeted in the Democrats' bill. By reducing funding for Medicare Advantage, the Democrats would pay for postponing the pay cut to doctors for 18 months. The legislation could result in $14 billion less for insurers over five years, though an estimate by a conservative House Republican caucus put the tally at $47.5 billion over 11 years. The White House has threatened a veto over Medicare Advantage cuts, arguing that the Senate Finance Committee is close to working out a compromise without cutting payments to private insurers in that program. Those negotiations, between Sens. Max Baucus (D-Mont.), the

finance committee chairman, and E. Grassley (R-Iowa), broke down when Senate Majority Leader Harry M. Reid (D-Nev.) decided to push ahead with the House bill after it passed that body Tuesday by a veto-proof margin. Aides said yesterday that no new talks had begun, and after the Senate reconvenes July 7, it will have three days to pass a fix before the HHS freeze is lifted. At one point during Thursday's debate, Reid literally hopped around the chamber, predicting Democrats would hold "at least" 59 Senate seats next year because Republicans toed Bush's line. "I don't know how many people are up here for reelection, but I am watching a few of them pretty closely," Reid said, staring at the GOP side of the chamber. "I say to all those people who are up for reelection: If you think you can go home and say, I voted no because this weak president, the weakest political standing since they have done polling, I voted because I was afraid to

override his veto -- come on." Minority Leader Mitch McConnell (R-Ky.), visibly angered by Reid's speech, offered temporary legislation that would forestall the pay cuts to doctors through July, but Democrats objected. Yesterday Jim Manley, Reid's spokesman, mocked Leavitt's 10-day delay "as nothing more than a fig leaf" to offer political cover to Republicans.

[Guest guest]

Charlie,

Actually had you seen some of my more interesting posts at the AC user board, I call it a Jon Cleese skit myself. "Here at the ministry of Scewing Up Healthcare Beyond Belief....." It is truely Amazing who screwy this all is. You really just can't make this stuff up if you tried. And never forget that the Medicare fees then tie into almost any and all commercial contracts and their fees. So screwing up things here is a windfall profit for their friends in the insurance industry too.

I find the fact the King and the Republicans were most concerned with making sure that the Managed Medicare and private fee for service Medicare Plans were not finally hit like primary docs are must interesting. I heard once that we pay these plans on average just about $1K dollars more per Medicare recipient for their being involved then if these same patients were still in the regular old fashion government run Medicare. So again because the Health Insurance Industry needs come before those of the patients or the providers the rest of us are all forced to suffer for their greed and profit.... Ya just can't make this CCHIT up.

"The Insurance Industry is a Legalized Cartel"

[Practiceimprovemen t1] Medicare Pricing Frozen As Congress Leaves TownMedicare Pricing Frozen As Congress Leaves TownUpon Thaw, Program's Payments to Doctors May Be Cut Almost 11 PercentBy KaneWashington Post Staff Writer Saturday, June 28, 2008; Page A03 With congressional leaders engaged

in heated brinkmanship, the Bush administration yesterday gave a reprieve to thousands of doctors expecting to get hit Tuesday with a 10.6 percent cut in Medicare payments. The Department of Health and Human Services will essentially freeze the current pricing system because Congress left town yesterday for a midsummer break without approving a price fix, Secretary Mike Leavitt announced. Congressional aides said the freeze could last 10 days. If the legislative dispute lasts beyond the new deadline, Leavitt said he hopes to retroactively pay doctors once the dispute is resolved. But there was no sign of cooling off on Capitol Hill. Yesterday, each side accused the other of playing politics with Medicare, the program that covers many health-care costs for the nation's elderly. Feelings were particularly raw after a Thursday night Senate vote in which members yelled at one another on the floor and left Democrats one vote short of the 60

needed to pass their version of the Medicare fix. "That display last night on the floor is something I've never seen," said Sen. Arlen Specter (R-Pa.). The roll call vote was held open for an additional 25 minutes so Sens. Barack Obama (D-Ill.) and Hillary Rodham Clinton (D-N.Y.) could make it to the chamber from their fundraiser at the Mayflower Hotel. Sen. Jim Bunning (R-Ky.) grew irritated about waiting for Clinton, the last to arrive, and called for "regular order" to shut down the vote. That led to a shouting match with Sen. C. Byrd (D-W.Va.), who yelled "Who are you?" and mockingly called his colleague a "great baseball man." Bunning, a Hall of Fame pitcher in the 1950s and 1960s, shouted back that he has the same rights on the floor as Byrd, the longest-serving senator in history and the chamber's leading parliamentary expert. The exchange ended with Byrd loudly laughing. The payment cuts to doctors are part of a 1997

balanced budget deal that trims the money going to Medicare, but the doctors have regularly staved off the cuts. They argue -- through their lobby, the American Medical Association, and the AARP -- that slashed payments would prompt many doctors to drop out of the system. Private insurance companies make a similar argument for Medicare Advantage, a program of private fee-for-service insurers and HMOs, that is targeted in the Democrats' bill. By reducing funding for Medicare Advantage, the Democrats would pay for postponing the pay cut to doctors for 18 months. The legislation could result in $14 billion less for insurers over five years, though an estimate by a conservative House Republican caucus put the tally at $47.5 billion over 11 years. The White House has threatened a veto over Medicare Advantage cuts, arguing that the Senate Finance Committee is close to working out a compromise without cutting payments to private insurers in that

program. Those negotiations, between Sens. Max Baucus (D-Mont.), the finance committee chairman, and E. Grassley (R-Iowa), broke down when Senate Majority Leader Harry M. Reid (D-Nev.) decided to push ahead with the House bill after it passed that body Tuesday by a veto-proof margin. Aides said yesterday that no new talks had begun, and after the Senate reconvenes July 7, it will have three days to pass a fix before the HHS freeze is lifted. At one point during Thursday's debate, Reid literally hopped around the chamber, predicting Democrats would hold "at least" 59 Senate seats next year because Republicans toed Bush's line. "I don't know how many people are up here for reelection, but I am watching a few of them pretty closely," Reid said, staring at the GOP side of the chamber. "I say to all those people who are up for reelection: If you think you can go home and say, I voted no because this weak president, the weakest

political standing since they have done polling, I voted because I was afraid to override his veto -- come on." Minority Leader Mitch McConnell (R-Ky.), visibly angered by Reid's speech, offered temporary legislation that would forestall the pay cuts to doctors through July, but Democrats objected. Yesterday Jim Manley, Reid's spokesman, mocked Leavitt's 10-day delay "as nothing more than a fig leaf" to offer political cover to Republicans.