Reply to thread

Message: <blockquote data-quote="diesel96" data-source="post: 742426" data-attributes="member: 9859">The Medicare “doc fix” is back in play on Capitol Hill, and its mere mention provokes a torrent of scorn and vitriol rarely seen among the generally mild-mannered community of policy mavens who inhabit the nation’s think tanks and universities. “It’s one of the worst pieces of legislation I’ve ever seen,” said Stuart Altman, a former adviser to Congress on Medicare who now teaches health policy at Brandeis University. “I don’t think I’ve ever felt so vindictive about a piece of legislation in my life.” “It’s a charade,” said Henry J. Aaron, a health policy analyst at the Brookings Institution. “Congress takes care of things but doesn’t actually do anything. They haven’t been willing to write up the full cost of changing the system, so the projected deficits don’t look as bad as they are.” In health policy circles, the “doc fix” has become emblematic of Washington’s worst habits: a potentially solvable policy problem run amok for about a decade now, bogged down in pure politics and accounting gimmicks. The “doc fix,” a last-minute infusion of funds to head off a looming doctor pay cut under Medicare, hits the floor this week via the tax extenders bill and, if passed, will stabilize Medicare payments through 2013 at a cost of $63 billion over the next 10 years, according to a Congressional Budget Office estimate. Without those funds, physician payments stand to drop 21 percent June 1. The “doc fix” stems from the method used by the government to pay doctors who serve Medicare patients. Ever since Medicare was created in 1965, the social insurance program has experimented with various formulas to determine the rate of doctor reimbursement. Officials have created complex formulas with wonky names — the Medicare Economic Index in the 1970s, followed by the Volume Performance Standard in the 1990s. Each has been shuffled out in favor of a new formula. The most recent incarnation of the Medicare reimbursement formula is called the Sustainable Growth Rate, put into place in 1998. The government uses the formula to set an overall target amount of spending for certain types of goods and services. Using Medicare spending in the late 1990s as a baseline, the SGR factored in overall economic growth to create a yearly budget. “It was enacted during a time period when physician payments were not growing rapidly,” said Paul Van de Water, an economist at the Center for Budget and Policy Priorities. “It was assumed that the relative slowdown was likely to continue.” But a formula that may have seemed sound in 1997 did not account for one huge detail: Medical spending has grown at a much faster rate than inflation. The SGR turned out to be totally unsustainable, leaving doctors with a reimbursement rate that did not keep pace with increasing medical costs, thus requiring a fix — not of the formula but of the payment. Read more: <a href="http://www.politico.com/news/stories/0510/37719.html#ixzz0qo12mry2" target="_blank">http://www.politico.com/news/stories/0510/37719.html#ixzz0qo12mry2</a> </blockquote>

Verification