High Stakes, Indeed
Mike Abrams, Executive Vice President of the Iowa Medical Society
In the association business, the stakes are always high. We are always a handful of votes on either side of tort reform, scope of practice policy, a Medicare cut, or some other issue that, at the time, looks like nothing will ever matter more.
But this seems to be a true moment in time, where the stakes have never been higher. It feels like a policy swath of this magnitude should be taken amidst clear bipartisan consensus, yet there are clear-thinking voices on both sides (please dismiss the fringe lunatics) who are expressing their positions with passion and reason.
Is a public option absolutely necessary, or is it the apocalypse? If it gains a foothold, then how long will it be before physician participation becomes a condition of licensure (as Medicare "mandatory assignment" laws have been enacted in states), or before the official government option fee schedule looks eerily similar to Medicare's? And how can physicians in states like Iowa trust that won't be the case when considerable political heft has heretofore not been able to right the reimbursement disparity?
The Sustained Growth Rate has been Exhibit A in proving Congress' inability to manage a health care system. SGR has literally no defender: it is condemned by Republicans, Democrats, Senators, Congressmen, Presidents, and cabinet secretaries. Yet it lives on and on and on.
That is not to suggest that I am a staunch defender of the status quo. The current system has flaws that are costly in dollars and raises legitimate questions about our nation's moral compass. But it seems that, in our haste to deliver on political promises, we are favoring nearly unaffordable short term solutions, rather than making fundamental changes that would mitigate the trajectory of health care expenditures and preserve what is good about our current system.
This is a big week for SGR activity. Floor votes in the Senate will be a strong indicator about how and whether we can anticipate true SGR reform this session. Stay tuned to www.iowamedical.org for updates on the activities.