FEDERAL UPDATE

The SGR Saga: Will It Ever End?

Vital Signs: Summer 2010

“Here we go again” does not even begin to describe it.

As this issue of Vital Signs went to press, the 21-percent Medicare payment cut was in effect, as Congress failed to stop the cut before June 1. Prior to that, what was considered by some to be the “best” proposal on the table would have stopped the cut for five years and made modest increases in physician payments, while leading again to significant cuts at the end of that period. The AMA opposed that proposal, which seemed doomed even before it received any serious legislative consideration.

None of the proposals considered in late May would have permanently changed the flawed SGR-based formula, as congressional leaders clearly believed there was insufficient political will in Washington to pass a higher-cost, long-term solution without the money to pay for it.

This entire nightmare is playing out amid the most toxic political environment of our lifetime, a comatose economy, and lots of promises from people in power who have yet to… well, put the money where their mouth is.

We do know that all the members of the Massachusetts House Delegation and Sen. John Kerry have voted with us each time on this issue. We remain grateful for their support. MMS advocacy is now focused on Sen. Scott Brown, who is critically important to our success on this issue.

In late May, the MMS formed a coalition of Massachusetts stakeholders that met with Sen. Brown and his staff in Washington. That coalition included the AARP Massachusetts, the Massachusetts Hospital Association, the Conference of Boston Teaching Hospitals, the Military Officers Association of America, and Philips Healthcare Division.

The MMS-led coalition emphasized that the Medicare crisis is as much about jobs (one in five Massachusetts workers is employed in health care) and the state’s economy (about 15 percent of which is based on the health care industry) as it is about access to care for the more than 1 million Medicare patients in the state and the 71,000-plus members of military families who get care through Tricare.

Notwithstanding any short-term patch that may or may not have been implemented after this issue of Vital Signs went to press, organized medicine is forming coalitions to strategize ways to get a long-term Medicare fix passed. The nationwide AMA ad campaign launched in June is one approach.

As we have been telling Congress for a decade, unless the band-aid approach is scrapped, the fiscal hole being dug more deeply with every short-term patch will only get deeper.

– Alex. Calcagno