24 February 2009

Two more tidbits

Obama said in his non-SOTU today that health care reform cannot wait another year, and "must" be enacted this year.   Interestingly, Elana Schor wrote today at Talking Points Memo:
"There is an acknowledgment on both sides that something has to be done" on health care, Senate GOP Conference Vice Chairman John Thune (SD) told me, adding openly that more than three members of his party "are gettable" for a health reform bill this year. ... "You could get a lot more than three Republicans" to back the coming health reform bill, another Senate GOP leader, Policy Committee Chairman John Ensign (NV), told me. The key, as he described it, is the process Democrats use for consideration of the measure.
Interesting.   I had assumed that the stimulus bill was a precursor and warm-up for a scorched-earth battle over health care.  That senior republicans are making conciliatory noises this early is encouraging indeed.   It could be a ruse, of course, and the process is only filled with a million potential pitfalls, but it would be an amazing political feat to see a national health care plan pass with more than one (let alone more than three) GOP votes.

On a slightly more wonky note, Joe Paduda over at Managed Care Matters delves into different political battle field and writes:
It looks like reimbursement for cognitive services - the 99xxx codes ... will be increased while payments for surgeries, imaging, and other 'procedures' will be reduced.

This just makes sense. Primary care physicians have seen their total compensation slide year after year, while those doctors specializing in 'specialties' have seen slight increases. There is a shortage of primary care docs - newly minted physicians can't afford their debts on $125k a year, so they have to specialize in one of the more lucrative areas if they are to have any hope of a decent income. ... Reducing compensation for specialists is going to ignite a political firefight - one that will be loud, violent, and ugly. It is also long overdue. There are going to be winners and losers in health reform, and one group that looks likely to lose is specialists.
It's not clear to me whether Joe has a source for this or if it's just a reading of the tea leaves by one with experience in the system.

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