Health Care Reform and the Broken Rule

by Jack Lewin August 20, 2009 10:09

We’ve been hitting the media particularly hard with our messages about both reform and the outrageous proposed payment cuts in the parallel 2010 CMS-issued proposed Medicare Physician Payment Rule, noting our membership’s focus on reform has been completely diverted to trying to undo the impending payment rule. People need to be clear that “health reform” and the “Medicare Rule” are 2 different and almost unrelated topics. The Rule is just the annual CMS announcement about changes in payment they will institute (supposedly based on sound data and methodology -- NOT!).

On the rule: All the CV societies and the Cardiology Advocacy Alliance are working together with us (as is Oncology) on getting the word out about how unfair the proposed Rule would be if implemented. At this point, we have about 12 House members ready to sign on to the Gonzales-Roger letter to the Secretary, asking that the CV aspects of the Rule not be implemented. We think there are more willing to sign, but with them out on recess it’s hard to know yet. On the Senate side, Senator Lincoln sent a letter for American Society for Therapeutic Radiology and Oncology addressing the cuts in the Rule, and we have other letters pending. Our Board of Governers and Chapters have been cranking out the letters and visits to members in the Districts. This is great advocacy, and we are all soooo grateful here to those who are working so hard.

On reform: the ACC conducted a satellite media tour on the topic from the National Press Club, reaching 15 stations across the country. An ACC op-ed appeared in Roll Call online, making our point that “basing health care reforms on quality and driving down costs will allow us to provide more coverage and make available more resources for education, the environment and other critical societal needs.” On some of these stories we were able to get the flawed Medicare Rule in there also, as something that exemplifies what a mess the current CMS payment structure is, and how this issue is stealing the energy for reform as we fight to get the Rule reversed before it is issued.

Also on reform: With little notice (somebody important probably cancelled out), I was asked to depart early from the NY CEO meeting to rush over to FoxNews.com Live with Alan Colmes on a panel to discuss the push for health care reform. We debated tort reform (me positive), the single payer option (me skeptical), and the need for payment reform (me positive) in what was a very stimulating conversation — so stimulating in fact that my fellow hospital administrator panelist (CEO of Universal Hospitals) was so frustrated apparently about hospital cuts and ‘public options’ questions that he walked off the set. I wasn’t able to get the Rule issue raised in my few minutes there though, but asked Colmes if we could have another chance to get our leaders on to talk about it.

Other societies have been busy beating the health care reform drum, too. Our own J. James “Jim” Rohack, M.D., F.A.C.C., President of the American Medical Association, appeared on “Larry King Liveto discuss health care reform and give us some background on why the AMA endorsed HR 3200. Dr. Rohack carefully avoided throwing his full support behind the details of the bill, saying the AMA endorsed it “to move the process forward” in order to increase access. Former Sen. Bill Frist, another panelist on the show, strongly rebutted the AMA position, saying we need to “stay at the drawing board” and listen to senators who are working toward bipartisan legislation that will “bend the cost curve.” The AMA is getting beaten up based on a lot of misinformation, and I told Dr. Rohack we'd send around a letter he’s writing to get straight the facts about AMA’s positions on the controversial issues.

Dr. Rohack did make an important note that “the reason HR 3200 is very important is there is a fatally flawed formula (SGRrrr) … that will affect seniors’ access to Medicare.” He continues that “at least … the House bill … fixes this fatally flawed formula once and for all.” 

*** Image from Flickr (maliciousmonkey). ***

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About the author

Jack Lewin has been chief executive office of the American College of Cardiology since November 2006. Under his leadership the College has continued to build upon its standing as a national leader in advocacy, with a particular focus on reforming Medicare, Medicaid, and the financing and delivery of quality health care. Learn more about Dr. Lewin.

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