With Congress returning from its spring recess to the first budget season with Republicans in control of Congress, Dr. Robert Wah, president of the American Medical Association, was on C-SPAN's Newsmaker along with Melissa Attias, staff writer for healthcare policy for CQ Roll Call, and Noam Levey, staff writer for the Los Angeles Times and Tribune newspapers.
The program was moderated by one of the original leaders of C-SPAN, Susan Swain, who asked Wah for a "quick primer" on pending legislation in the Senate to provide what is known as the "doc fix."
Wah responded by referring to the topic as "a sustainable growth-rate program" that was originally enacted in 1997 in order to control the costs of Medicare, but it has led to "about 17 patches over the last 10 or 12 years," each of which only covered the current period at the time. By kicking the can down the proverbial road, a lot of interest liability has built up, so that if Congress doesn't act by April 15, a 21 percent cut in physician payments would take effect. As Swain expected, Wah bristled at the use of the term "doc fix," because "it isn't doctors that need to be fixed here, it's Medicare that needs to be fixed." He added that physicians are seeking a long-term solution that would provide stability for everyone associated with the program.
Swain asked whether a failure to fix Medicare would lead to a decrease in the willingness of physicians to take Medicare patients, and Wah stated, "Absolutely. Like any business, if doctors are faced with a 21 percent cut in their payments from the Medicare program, it will be more challenging for them to continue to see their Medicare patients. And if that happens, the Medicare patients will have a harder time finding doctors that can take care of them, so they may have to drive further or call more doctors' offices."
Levey offered as a "presumption" the notion that the Senate will act, and he asked Wah for more details on the "substantial" changes that would be in the legislation. Wah, who served as an active-duty navy physician for 23 years, hastened to say that in addition to Medicare patients the Tri-Care program that covers service members and their families is subject to the same rules as Medicare is. He went on to say that the bill would put in place other policies and programs to enable physicians to take better care of the Medicare and military patients by standardizing reporting requirements and reauthorizing the Children's Health Insurance Program.
Attias asked, given that the legislators were optimistic last year that Congress would agree on a long-term solution, when did Wah realize that it could happen this year? (This writer expected Wah to answer that this occurred as soon as the returns were in from last year's election.) He said that the policy had been "hammered out in a collegial way" by all the actors last year, and with the window open again, the House passed H.R. 2 with 392 votes, which Wah called "a spectacular achievement," so "overwhelming support" has been demonstrated to get this done. Wah added that President Obama has already committed to sign the bill.
Levey noted that the reason given for the Senate not bringing the bill up before the recess was that "it was not, technically, paid for, so that in its current form it would add to the deficit." Wah acknowledged the short-term increase in the deficit but argued that other features of the bill would save money during time, and he expressed hope that all sides would compromise, and despite the potential for amendments that could sidetrack the bill, he still hopes it will pass by April 15.
(Archived video can be found here
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