Wednesday, June 3, 2009


The Medicare Payment Advisory Commission (MedPAC) is about to get a promotion. MedPAC is the independent congressional agency that advises Congress on Medicare payments/reimbursements. Up till now, MedPAC's suggestions were just that; suggestions to be implemented or ignored by Congress. According to the Washington Post, President Obama is considering two options that would grant MedPAC more power. The first is a resolution from Jay Rockefeller which would move MedPAC into the executive branch. This would make MedPAC a de facto autonomous agency that could unilaterally set Medicare payment schedules and fund policy initiatives. (This is the vaunted "Federal Reserve" of healthcare envisioned by Tom Daschle.) The second would simply allow MedPAC to fast track their recommendations through Congress without the possibility of filibuster or amendment.

Either way, we're looking at a small agency that is about to assume the command post of how we determine reimbursement for physicians and other health care providers. Taken alongside rhetoric of "health care reform is entitlement reform", this sort of development ought to be frightening for any practicing physician. Here's $150 for that gallbladder you did at 2am, Dr. Parks. Nice doing business with you. Thanks for helping America get back into the black!


Anonymous said...

This way past ridiculous. WTF. This government knows no boundaries. The sad reality is that everything they touch turns to poop. I'm with Ron Paul and Jessie Ventura. Don't start the revolution without me. Companies should stop paying into FICA. Maybe some of these programs should be given to the states to control? Bankers get bonuses and the regular american gets the shaft.

Anonymous said...

I believe that banking institutions are more dangerous to our liberties than standing armies. If the American people ever allow private banks to control the issue of their currency, first by inflation, then by deflation, the banks and corporations that will grow up around [the banks] will deprive the people of all property until their children wake-up homeless on the continent their fathers conquered. The issuing power should be taken from the banks and restored to the people, to whom it properly belongs."

-Thomas Jefferson

shadowfax said...

I think you've got this wrong. They're not going to set provider reimbursement rates (that still falls under the RUC), but they will set rates for medical devices, decide which devices medicare will pay for, and may even someday provide rational guidance for rationing care like not paying for dialysis on demented 95 year olds.

DrWes said...


"Rational guidance" for the system does not equate with rational guidance for the individual - ever.

retired tom said...

If any physician believes that he/she will benefit from the "reforms" being touted, they are in my opinion, either sadly misinformed or extremely naive.

The cost that Obama is talking about reducing is what gets paid to the people who do the work. The physicians cost of business will not be decreased-rather the gap between cost and revenue will continue to narrow to the point that physicians will seek employment, or seek other professions. Health care has been reduced to a common commodity-"days per thousand = barrels of oil".
I used to laugh at the signs that read " The End is Near"...Me thinks the End is Here

Anonymous said...

...and the challenges ahead.

if i were to pick an animal to depict our healthcare system, i would consider a hippo.