President Obama has set a March 18 deadline for passage of a health care plan that draws largely from legislation crafted by the Senate. An AMA update on health system reform negotiations reveals that the House and Senate are negotiating changes to the Senate-passed health system reform bill that would address concerns House members have with that legislation. Complicating the efforts are the procedural restrictions that would apply to the budget reconciliation bill that Congress intends to use as a legislative vehicle for making those changes.
One of the outstanding issues is the scope and authority of the proposed Independent Payment Advisory Board (IPAB), which the NCMS and the AMA oppose. The IPAB would make recommendations to Congress for reducing the rate of growth in overall Medicare spending if total spending exceeds a new, program-wide expenditure target. The AMA says the new target system is very stringent and does not apply equitably across Medicare provider groups. In addition, the “fast track” authority the bill would grant these recommendations would require a three-fifths vote in both Chambers for Congress to overturn them, a requirement reminiscent of medicine’s experience with Medicare’s sustainable growth rate (SGR).
Physicians need to call their Representatives and Senators to voice support for the NCMS principles of health system reform that would provide adequate access for patients, a sustainable workforce and support improved quality and administrative effectiveness while managing costs. Additional information concerning health system reform is available at http://www.ncmedsoc.org/healthreform.