THE TREATMENT DECEMBER 18, 2009
As health-care reform inches closer to the finish line, at least a few opponents of the Senate bill are stepping back from all-out war. Earlier this week, Ben Smith reported that the two surgeons’ groups—the American College of Surgeons and the American Society of Plastic Surgeons—demanded that their names be pulled from an attack ad that lists “Doctors Against the Plan” who “understand that under the proposed rules there will be longer waiting times and rationing of care for seniors.” The group behind the ad, “Rethink Reform,” claims that they were justified in citing the surgeons’ organizations based on a Dec 1 letter they sent to Harry Reid that listed their reasons for opposing the current Senate legislation.
As Smith notes, the surgeons’ protestations are clearly a sign that they’d rather be on the inside of the negotiations with the Democratic leadership. Such a move puts them closer to the (relatively) more amicable position of the American Medical Association, which voiced its grievances about the Senate bill but still says that it wants to be generally supportive of the reform effort.
For both docs and surgeons alike, one of the biggest remaining problems with the Senate legislation is its failure to include a fix for the flawed Medicare payment system for doctors. While the House passed a $210 billion Medicare “doc fix”--an unfunded, $210 billion bill passed separately from the main reform legislation--the Senate rejected a similar proposal last October, prompting the surgeons to decry the upper chamber’s reform effort. While there’s little sign that the Senate would be willing to take up the measure again, there is one development that may have quelled an outright rebellion--the decision to reject the Medicare buy-in. Though the decision to drop the buy-in hasn’t done anything to address the doc payment problem, the Democrats have at least taken one credible threat off the table.
To be sure, the surgeons are still making an aggressive push to eliminate other provisions they don’t want in the bill, including Rockefeller’s amendment to strengthen the MedPAC commission and the tax on cosmetic surgery. But they’re pulling up a seat at the bargaining table, not marching away from it--and they’re not going to let other groups try to “kill the bill” in their name.
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