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Fixing the Doctors Good and Hard: Impact of the Health Bills on the Medical Profession

While some prominent physician groups at the national level like the American Medical Association have suggested that the typical doctor on net would be better off if Congress’s health care legislation were to pass—mainly because of all the changes in Medicare payment methodology—those groups have generally failed to acknowledge a number of the critical issues. Based on the provisions of the House health care bill (H.R. 3200), here are the simple facts:

• As millions of Americans are moved from private insurance to public coverage, with the introduction of a Medicare-like public plan and a massive Medicaid expansion, once reform is fully implemented annual reimbursements to doctors could fall by $31.7 billion.

• Although the typical physician could be better off –as the AMA contends–if reform included a replacement of sustainable growth rate (SGR) formula- the formula for updating Medicare physician payment- the House legislation could reduce physicians’ annual net incomes by $9.3 billion, or roughly $13,117 per doctor.

• Even if the SGR were replaced and physicians at the national level would on average see their net annual income increase under the reform, there would still be significant variations at the state level. That said, groups like the American Medical Association at the federal level might not be looking out for its state affiliates or actual doctors on the ground in some areas of the country. For example, if reform with a “robust” public option were to pass Congress and receive President Obama’s blessing, physicians in Maine could see their net annual income decline by $271.7 million, with an average loss in income of $55,692 per physician.

Would doctors in Maine really care to know that if the AMA plays its card right with health care reform, on average, at the national level their counterparts might potentially come out ahead on the other side? It’s doubtful. But that’s how top-down “change” imposed by Washington works. It always works that way when the “change agents” are in the business of securing more power and control.

  • Author: Greg D'Angelo
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13 Comments

October 20, 2009 Jason, Pittsburgh PA writes:

It’s amazing the AMA would back this plan. Despite any promised now handed out by congress, motivations will undoubtedly change once the plan is implemented. Does the AMA think when congress decides cuts need made, that they’ll have any control over it? The gov’t will already have their boot on the throat of those doctors the AMA claims to represent, and there be nothing they can do but take it.

Jason V.
ProudProfiteer.com

October 20, 2009 Deedeern, San Diego writes:

Less than 20% of physicians across American are represented by their “profession’s” organization- the AMA (American Medical Association). This holds true for nurses as well- the ANA ( The American Nurses Association}. Both are partisan organizations, with their own lobbyists! They are not the Voice for Nurses and Doctors in the real world of health care practice- from patient care to health care administration and financial management.

October 20, 2009 b nuckols Texas writes:

I’ve repeatedly heard AMA and AAFP leaders claim that the only way to stay in the conversation (”to have a place at the table”) is to agree to a “Yes, if . . .” stance: If the conditions we’ve named - including ending the SGR, implementing true tort reform, supporting the primary care workforce and providing coverage for all Americans - are met, then we’ll support your “reform.”

I don’t see how all of the above can be achieved. I’m afraid that the leaders may back down when their members are faced with that cut that we face due to the SGR. Obama told the AMA that tort reform was off the table, and no one’s figured out how to pay for the rest without increased taxes.

I would like to know what the proposal of Heritage’s board would be concerning the SGR and the 21% cuts we face. Medicare patients have paid in for 41 years, they have a contract. Doctors - at least primary care docs - can’t afford to take a 21% pay cut for a large part of their patients. The only recourse left is the complicated process of “opting out” for two years and charging patients directly.
(Who thinks this Administration will allow that last?)

October 20, 2009 William, Illinois writes:

In another article, “If it’s to urgent, why would 2 elections pass before health care kicks in”. I have a solution for holding those accountable for what happens in 2013 when this plan kicks in. We the People will make a list of ALL those that vote for this plan, and we will make it a point to vote them out THIS NEXT ELECTION REGARDLESS, and I think we should send them ALL a letter to that intent. http://openletter.avoiceofthepeople.com

October 20, 2009 Bobbie Jay writes:

was wondering when this would come?? We rally, write and call. THE AMERICAN PEOPLE DON’T WANT THIS!! WHAT NOW??

October 20, 2009 Frank, Hagerstown writes:

The health care system became what is through free market enterprise. The problems in health care financing (inane insurance rules, bankrupt Medicare) are a result of governmental interference. Now government has decided that the cure for the ills it has inflicted is to fully co-opt the system. When Obamacare is implemented, along with all of its unintended consequences, health care as we have come to know it will no longer exist. But this the fundamental change he promised. I hope people are happy with what they get because they are not getting what they think they are.

October 21, 2009 The Elephant's Child, Seattle writes:

Whenever the left promises “sustainability” you need to check your wallet. Sustainable pay for doctors will gradually decrease. Sustainable energy depends on “capacity ratings” announced by developers which has nothing to do with the amount of energy actually produced by a wind farm (only produces any when the wind blows) or a solar array (which only produces energy when the sun shines. It is the new buzz word, and should flash on and off like a stoplight, for it is as reliable in predicting a lie as is the phrase “Let me be perfectly clear.”

October 21, 2009 RagingElephants.org » News for 10/20/09 writes:

[...] Fixing the Doctors Good and Hard: Impact of the Health Bills on the Medical Profession http://blog.heritage.org/2009/10/20/fixing-the-doctors-good-and-hard-the-impact-of-the-big-health-bi... [...]

October 21, 2009 The AMA is Selling Out its State Chapters | www.statehousecall.org writes:

[...] the beltway may be hurt: “groups like the American Medical Association at the federal level might not be looking out for its state affiliates or actual doctors on the ground in some areas of t….”  The hit that doctors will take depends in large measure on how the final bill changes [...]

November 6, 2009 Pelosi’s Procedural Plan to Pass Health Care | Fix Health Care Policy writes:

[...] Payment Reform Act, also known as the Doc Fix. This is a procedural gimmick that allows the costly Doc Fix bill to be combined with H.R. 3962 after the bill passes the House. This allows Congressional Leaders to [...]

November 7, 2009 It can’t be done legally, so: Pelosi’s Procedural Plan to Pass Health Care « Conservative Thoughts and Profundity writes:

[...] Payment Reform Act, also known as the Doc Fix. This is a procedural gimmick that allows the costly Doc Fix bill to be combined with H.R. 3962 after the bill passes the House. This allows Congressional Leaders to [...]

November 7, 2009 House Calls? – Blog Watch writes:

[...] Payment Reform Act, also known as the Doc Fix. This is a procedural gimmick that allows the costly Doc Fix bill to be combined with H.R. 3962 after the bill passes the House. This allows Congressional Leaders to [...]

November 13, 2009 Pelosi’s Procedural Plan to Pass Health Care | Conservative Principles Now writes:

[...] Payment Reform Act, also known as the Doc Fix. This is a procedural gimmick that allows the costly Doc Fix bill to be combined with H.R. 3962 after the bill passes the House. This allows Congressional Leaders to [...]

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