Baucus Proposal

In case you're interested, here is the response to the latest Senate health care reform proposal from the American College of Surgeons along with approximately 20 other surgical organizations.

Letter to Senate Finance Committee Chairman Max Baucus

There are several concerns raised in the letter, including:

In 2011, without further legislation to correct the problem, physician payments from Medicare would be cut by 25%. If that were to happen we would see immediate, massive non-participation by physicians in Medicare. Few if any practices could afford to keep the doors of their practices open long with a 25% reduction in income. That in turn would result in severely restricted access to care for Medicare patients.

The creation of a Medicare commission would remove oversight of the program from Congress and give it to unelected, unaccountable individuals who could conduct business with uncertain transparency.

The PQRI is essentially an unfunded mandate on physicians. It's one thing to provide quality care routinely. It's another thing to have to document that care for each patient and submit separate reports to the government in order to receive payment for that care. It requires a great deal of time and paperwork, which is why few doctors have participated in the program to date. It's not that they aren't doing the things the program requires. It's that it is not worth the time and expense required to earn the small "bonuses" that are currently paid out. With this bill, the program becomes mandatory and rather than paying extra for those who meet the standards, it penalizes those who do not. The entire cost of participation will therefore be borne by physicians.

This bill does nothing to address tort reform, which is a major factor in controlling the escalating cost of medical care in this country.

It concludes with ideas for real reform which will address the issues of availability, cost containment, and continued improvement in quality.