Doc Salaries Cut

[Doctor D]

http://cnnwire.blogs.cnn.com/2008/07/15/bush-vetoes-medicare-bill-2/

Bush vetoes Medicare bill
Posted: 01:48 PM ET
WASHINGTON (CNN) — President Bush vetoed Tuesday a bill that would have halted a cut in Medicare payments to doctors. “This bill is objectionable,” the president said in a statement.
The Senate passed the measure — which would reverse a 10.6 percent cut in Medicare payments to doctors — last week, after they voted 69-30 to end a GOP filibuster on it.
The vote was nine more than the 60 votes needed to pass the bill and two more than needed to override a presidential veto.

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[deleted74029]

I know it probably depends on specialty, but anyone know about how much of a physicians income is affected by medicare? I guess what I'm asking is how many patients usually have medicare?

 

[bcat85]

They overrode the veto, so it doesn't matter if he signed it or not.

 

[EpiPEN]

They overrode the veto, so it doesn't matter if he signed it or not.

Yeah i was confused about that when I read about the post. So the bill got passed right? and so no medical cut?

 

[bodonid]

I know it probably depends on specialty, but anyone know about how much of a physicians income is affected by medicare? I guess what I'm asking is how many patients usually have medicare?

more than you'd think. and private insurance contracts don't go unaffected by things like this.

 

[Decicco]

more than you'd think. and private insurance contracts don't go unaffected by things like this.

My mom is a physician and she says that it will make little difference. She said that as new technology comes out, physicians charge more than they had in the past. This cut in medicare income, which fortunately didnt pass, would just offset that.

 

[Instatewaiter]

My mom is a physician and she says that it will make little difference. She said that as new technology comes out, physicians charge more than they had in the past. This cut in medicare income, which fortunately didnt pass, would just offset that.

No decicco I think you missed the point of the bill. the bill would REVERSE automatic cuts in medicare. When medicare spending exceeds what was budgeted, it has built in compensations. One of those is to decrease physician compensation. This bill was going to STOP a cut in compensation.

The major impact that this will have is going to be on access to healthcare.

For years, doctors wouldn't take new medicare patients because they would LOSE money. Not lose profits, actually lose money by seeing the patients. Doctors didnt want to abandon their current patients so they kept them on (traditionally) despite losing money. Now, with the most recent cuts, dont be surprised if doctors dump current patients.

 

[Instatewaiter]

Depending on the hospital you work with and the patient population, this could drastically affect income.

 

[DrBowtie]

Cash is King!

 

[frikarika]

Ok so..... Bushed vetoed it, but according to the article "The vote was nine more than the 60 votes needed to pass the bill and two more than needed to override a presidential veto." So is the bill going to go back to congress and the senate again to be voted on?

 

[bcat85]

Ok so..... Bushed vetoed it, but according to the article "The vote was nine more than the 60 votes needed to pass the bill and two more than needed to override a presidential veto." So is the bill going to go back to congress and the senate again to be voted on?

I think it passes since there is a veto-proof margin. It would be ultra-redundant to revote on it. So by this passing, the Medicare cuts do not occur... Thankfully.. for a country so "committed to improving access to healthcare", this would have chopped a bunch of old folks off at the knees.

 

[nogolfinsnow]

I think it passes since there is a veto-proof margin. It would be ultra-redundant to revote on it. So by this passing, the Medicare cuts do not occur... Thankfully.. for a country so "committed to improving access to healthcare", this would have chopped a bunch of old folks off at the knees.

No, they have to re-vote. There is always a chance that some of the Republicans (or I guess anyone) who voted for the bill could change their minds and vote against it on the re-vote. Doesn't seem like that'll happen though.

 

[Decicco]

No decicco I think you missed the point of the bill. the bill would REVERSE automatic cuts in medicare. When medicare spending exceeds what was budgeted, it has built in compensations. One of those is to decrease physician compensation. This bill was going to STOP a cut in compensation.

According to NYT: "President Bush cast a futile veto on Tuesday, rejecting a bill that would protect doctors from cuts in their Medicare payments. But hours later, the House and Senate voted to override the veto, making the Medicare measure the fourth bill to become legislation over Mr. Bush’s opposition."

later...

"The bill cancels a 10-percent cut in payments to doctors that would otherwise occur automatically because of a statutory formula that reduces payments when spending exceeds certain goals. The president said he supported the main objective of the bill, to forestall reduction in physicians’ payments, but that he had too many reservations about other aspects of the legislation."

So, mostly good news for people who care about the healthcare system or people in general..

 

[TehDoc]

So what the **** does the bill do? Passing it = cut and rejecting it = no cut?

 

[2docornot2doc]

passing the bill stops the pay cut for doctors.

bush tries to stop this bill.

congress will force the bill through.

so the medicare pay cut for doctors will be stopped.

 

[EpiPEN]

So what the **** does the bill do? Passing it = cut and rejecting it = no cut?

passing it stops the cut

so hurray for passing

That's my impression at least

 

[J ROD]

Bill was to stop doc's pay from being cut.

Bush said veto and the cut was to go through.

Legislature said override and reversed his veto.

SO, the cut will not happen and doc's pay will be saved!!

 

[ChubbyChaser]

Bill was to stop doc's pay from being cut.

Bush said veto and the cut was to go through.

Legislature said override and reversed his veto.

SO, the cut will not happen and doc's pay will be saved!!

and all is well in the world

 

[Perrotfish]

http://www.washingtonpost.com/wp-dyn/content/article/2008/07/15/AR2008071501361.html?hpid=topnews

it's official, veto overridden. You can thank the AARP, aparently.

Funny thing is that Bush didn't want the cut either, he just didn't want to pay for not making the cut by charging insurance companies (the plan with this bill)

 

[Decicco]

Not to be a "negative nelly," but inflation eats away at the value of these reimbursements anyway...

 

[EpiPEN]

Not to be a "negative nelly," but inflation eats away at the value of these reimbursements anyway...

negative nelly

 

[ChubbyChaser]

Not to be a "negative nelly," but inflation eats away at the value of these reimbursements anyway...

oil dropped 6+ bucks/barrel today as well..

 

[Instatewaiter]

Not to be a "negative nelly," but inflation eats away at the value of these reimbursements anyway...

Not by an immediate 10 percent

 

[Lukkie]

a lot of you need to get your head out of that examcracker book and turn on the news once in a while. maybe learn how the government works.

 

[Pedsbro]

a lot of you need to get your head out of that examcracker book and turn on the news once in a while. maybe learn how the government works.

http://www.youtube.com/watch?v=mEJL2Uuv-oQ

 

[TehDoc]

a lot of you need to get your head out of that examcracker book and turn on the news once in a while. maybe learn how the government works.

Haha, after a government class in high-school i don't think i've looked back since way back then.

 

[harposnarpo]

I forget the precise term, but Medicare is a "price-setting policy behemoth." Since it is such a big chunk on the demand-side of medicine, private insurers set their prices off of Medicare's index.

So, a decrease in Medicare reimbursement for XXX causes other, private insurers, to decrease their reimbursement for XXX as well.

 

[Doctor D]

Medicare sets the standard for private insurance companies so the cuts are considered to be across the board. Also to the poster who asked, anyone over the age of 65 I believe will have medicare. This portion of the population uses more healthcare than any other portion.

 

[bcat85]

and I forgot this earlier... but WTF GOP?!!

 

[Perrotfish]

and I forgot this earlier... but WTF GOP?!!

Again, to be fair, they weren't fighting to keep the cuts. They were fighting to kill that bill so that they could introduce a new bill to stop the cuts that financed itself some other way. The current bill finances it by charging insurance companies. I have no idea how the GOP wanted to finance it (though I'm guessing deficits).

 

[WDeagle]

So if insurance companies are charged more to finance this bill wouldnt this lead to insurance companies eventually cutting reimbursements anyway and/or charging more for insurance? From what i understand the problem for physicians isnt just medicare but the fact that insurance companies base how much they reimburse doctors based on medicare. Can somebody who knows more about the subject comment.

 

[TheElement]

So if insurance companies are charged more to finance this bill wouldnt this lead to insurance companies eventually cutting reimbursements anyway and/or charging more for insurance? From what i understand the problem for physicians isnt just medicare but the fact that insurance companies base how much they reimburse doctors based on medicare. Can somebody who knows more about the subject comment.

So you're saying if salaries are cut, insurance reimbursements will follow suit. If they aren't cut, they still decrease? My head just hurts thinking about this cycle.

 

[cbrons]

As reimbursement rates for medicare go down, the reimbursement rates for private insurance goes down.

 

[Narmerguy]

Again, to be fair, they weren't fighting to keep the cuts. They were fighting to kill that bill so that they could introduce a new bill to stop the cuts that financed itself some other way. The current bill finances it by charging insurance companies. I have no idea how the GOP wanted to finance it (though I'm guessing deficits).

Possibly but firstly I doubt that bill probably would have been passed and secondly I'm not entirely sure that the bill would ever be seriously introduced beyond talking points. I think the GOP was simply showing that corporate interests override physician interests which is in line with how they currently operate.

 

[Lshapley]

Ugh, this bill was not about cutting physician payments. Nobody in the government wanted to do that. This bill is about removing private insurance companies from Medicare. The 10% doc cut is being paid for by taking the money from the private medicare insurance companies that are being paid about 17% more than traditional medicare. The republicans want the private option (they always do), and the democrats are in favor of the government program (once again, they always are). It is really a traditional battle, it just happened that the democrats had the ace up their sleeve with this paycut. Seems to me like the first time the democrats have won a legislative battle in 15 years.

 

[nogolfinsnow]

My mom is a physician and she says that it will make little difference. She said that as new technology comes out, physicians charge more than they had in the past. This cut in medicare income, which fortunately didnt pass, would just offset that.

I doubt all physicians felt the same way. An ENT office I know (big time elderly patient population) was not going to hire a replacement for a employee who left if the cuts had gone through. This cut would have affected lots of doctors AND patients.

And, as posters aid before, most insurance companies use Medicare reimbursement as a starting point when deciding how much reimburse. If a company says they'll reimburse for 115% of the medicare rate, and the medicare rate drops 10%, well then the docs just lost some money.

Bush says "taking choices away from seniors to pay doctors is wrong." But Medicare Advantage costs the gov't more per person than traditional Medicare... Of course, no one ever claimed he had a brain.

 

[Nilf]

You are missing the point that the paltry 1.1% increase, which Congress throws in after YEARS of no reimbursement hike, is basically a CUT. Check frontpages in NYT and WSJ. Inflation was 1.1% in THE LAST MONTH ALONE.

So, everything is getting more expensive, while Medicare reimbursements are staying the same. This means that doctor's salaries are getting squeezed, slowly but surely.

Having said that, I am glad that the political spectacle accompanied by the Medicare cut took place. The uproar that it generated was as close as actual strike as physicians will ever get. It also created brand new political reality--irregardless of the veto repeal, physicians WILL be slowly backing off from medicare. The paltry 1.1% increase won't change it.

This brouhaha showed that sudden and large Medicare cuts are politically untenable. The only way Congress can stop further increase in healthcare costs is by CURTAILING THE ACCESS, and by SLOWLY PHASING MEDICARE OUT. This is taking place as I'm typing this.

Take home message for you: reimbursement will be going down across most specialties.

 

[Lshapley]

The only way Congress can stop further increase in healthcare costs is by CURTAILING THE ACCESS, and by SLOWLY PHASING MEDICARE OUT. This is taking place as I'm typing this.

Sorry, Nilf, I disagree with your read of what is and will be happening. What just happened was an end to the republican movement towards the privatization of social services. Medicare will slowly and surely lose its private plans in the coming years, and social security will not be privatized. The crux of the doctor "strike" also showed that congress can not phase out medicare, this is a politically untenable position. The AARP will overthrow the government (ok, not likely, but they will harass their reps relentlessly).

Right now we are at a crisis point in our history. This vote, coupled with the government bailout of the financial sector (Fannie and Freddie, Bear Sterns) is showing that there is a pendulum swing towards a more socialist state. I am not saying that we will become the next France, but it seems that when push comes to shove, our representatives have more faith in government regulation than they have previously expressed. It seems that there is only faith in the free market regulating itself when everything is coming up roses. It is a very interesting phenomenon.

 

[bcat85]

Possibly but firstly I doubt that bill probably would have been passed and secondly I'm not entirely sure that the bill would ever be seriously introduced beyond talking points. I think the GOP was simply showing that corporate interests override physician interests which is in line with how they currently operate.

They're in a lot of trouble. Physicians have always been *generally* pretty conservative. Even worse... So have old people.