| |
February 2007
Volume 71 |
Number 2
|
|
|
Turning Anger Into Action
Ronald Szabat, J.D., L.L.M.,
Director
Governmental and Legal Affairs
lot of upset and anger has followed quickly on the
heels of the rebuff physicians took from the last
Congress in late December 2006. This anger, bordering
on outrage in a few instances, has many different
roots, but it is palpable in some conversations
with rank-and-file membership.
First, all Medicare physicians, including anesthesiologists,
are now facing new cuts of approximately 10 percent
in 2008 due to the deliberate short-funding, or
patch, of last year’s sustainable growth rate
(SGR) cuts. As is now widely known, some departing
congressional Republicans were more interested in
enacting one last $38-billion tax cut for big business
interests and far less interested in setting Medicare
physician payment on a sound footing. By their actions,
they allocated only $3 billion toward the $12 billion
needed to avert the Medicare SGR cut for 2007, meaning
that the money hunt will be worse for 2008 and beyond.
The old analogy about digging yourself out of a
far deeper hole applies. Maddening indeed!
Many hospital-based physicians, particularly anesthesiologists,
also are justifiably upset about Medicare five-year
review and practice expense changes that are regulatory
in nature but have reduced immediate Medicare receipts
by about 8.9 percent for 2007, with smaller related
cuts expected over the next couple of years unless
our efforts stop them. ASA is on the case with the
American Medical Association and others who are
crunching numbers for a new and fairer practice
expense survey, but that will take time. The clenched
teeth continue!
Additionally physicians also feel betrayed that
the faith they keep with federal and state governments
to treat the elderly, disabled, poor and uninsured
on a daily basis is rarely acknowledged or praised
but is instead taken for granted more and more each
year. Is anyone in government listening?
So what’s a frustrated anesthesiologist to
do? Well, the short answer does not lie in deciding
to throw in the towel and give up. After all, are
physicians quitters? Do you walk away when the going
gets tough? Do you abandon patients in medical distress?
Of course the answers are “no, no and never.”
So, too, it must be the case when it comes to fighting
for better treatment from Congress and the Administration.
Because if we give up, that’s just what those
fighting against us and not supporting us want!
At the same time, here’s a snapshot of our
reality:
1) Anesthesiology’s Medicare
payment problems go back to 1992 and the advent
of the Resource-Based Relative Value Scale when
our initial conversion factor was set unacceptably
low. ASA has worked constructively for the past
decade-plus to right this wrong, and Medicare anesthesia
payment would be far, far lower without the unrelenting
and successful ASA efforts to correct the errors
that came with the new Medicare payment system.
Still, the battle goes on, and the situation will
not be turned around over night.
2) All of medicine is under siege from Medicare
just as the Balanced Budget Act of 1997 and the
evil and regressive SGR formula intended. As I hope
you read in last month’s column, even the
Secretary of Health and Human Services is willing
to blame physicians for this problem, as if they
were driving the demand for Medicare services. (You
have sent him a message that he is wrong, right?).
3) ASA has a legislative and regulatory strategy
for relief, with enhanced resources being put into
place, but it will involve everyone working together
with the new Democrat congressional majority and
keeping intense pressure on the Bush Administration
to ensure that our message is heard.
This is the reality of the situation, plain and
simple. Still angry? Perhaps. But dedicated to action
and taking your message to Congress and President
Bush? I sincerely hope so! There is a new order
on Capitol Hill and a real chance for bipartisan
cooperation, and all ASA members need to be making
new friends and cementing old relationships with
politicians of all stripes!
As Congress gears up and our issues are reframed
to win, every ASA member must do his or her part
to help us succeed. Please watch our ASA Web site
under “What’s New” for calls to
action, and then please follow through!
To do less is to be part of the problem. In which
case, you will then have to be mad at yourself!
(And we don’t want that, do we?
| |
|
.Ronald Szabat, J.D., LL.M., is ASA Director
of Governmental Affairs and General Counsel,
managing its Washington, D.C., office. |
|
return to top |
|