How do they do that?

The Democrats in Congress are trying to make a deal with the AMA (and ostensibly all doctors) in that they will prevent cuts in Medicare payments to physicians in return for physician support of health care reform. 

Let’s think about this, Medicare is going bust, but to get reform we can add $250 million to the cost by not following a 1997 law that lowers physician payments.  At the same time health care reform is going to control costs and improve the quality of care, and be beneficial to doctors to the extent they support the current versions. 

If health reform has any chance of lowering costs, making health care affordable if you will, and of improving the quality of care, such reform must directly affect physicians and the rest of the health care system.  That is, fee for service practice must change, overcharging and self-referrals must change, the use of tests must be better defined and monitored, etc.  In short, health care must be more efficient and in some way physician income must be affected, especially going forward. 

So, which is it, is health reform business as usual for doctors or is it changing the health care system to achieve the stated goals? It can’t be both. 

West Wing solution session
West Wing solution session

But wait, according to Nancy Pelosi, it is no longer health care reform, it is health insurance reform.  Now it’s clear to me, we lower the profitability of health insurers and in the process we improve the quality of health care and lower the future rate of health care inflation.  

Of course, what was I thinking?

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