12 May 2009

The Proceduralists' Lobby Strikes back

I must have missed this: Last week, 90 bipartisan members of the House of Representatives sent a letter to House leaders expressing their opposition to one proposed option to increase funding for primary care services as part of health care reform.  The letter, written by Reps. Shelley Berkley (D-NV) and Mark Kirk (R-IL), stated the undersigned Members would not support increasing payments to primary care by reducing payments to specialists and other health care providers.

This is in response to the floated policy which would reduce payment to proceduralists to fund a 5% increase in primary care.  I knew the specialties would fight it, but I didn't expect that they had this much clout, especially being such a fragmented group of interests.

It will be interesting to see whether this is just posturing or whether this bipartisan group has enough clout to block the Senate's proposal.



7 comments:

JimII said...

I'm not sure how smart it is to make a big deal about salaries in our current environment. Do we really think it is a big leap from talking about how much money bank executives make to talking about how much money lawyers and doctors make?
FYI:
http://swz.salary.com/salarywizard/layouthtmls/swzl_salarycenter.html

I know a number of lawyers taking pay cuts that are secretly suggesting that maybe we were making too much before. Not that we would want to tell our clients that.

shadowfax said...

Well, this is the problem. The private practice attorney taking red car-blue car cases probably ekes out a slim living, just as a pediatrician of family practice doc does. But a lawyer at a large well-connected democratic partisan hack firm probably is paid as well as the average urologist. Now the analogy falls apart because the lawyers are all parasites feeding off of the blood of society. But the primary care docs are terribly underpaid and the specialists are terribly overpaid.

So what we are arguing here is for a rebalancing of the compensation of the various specialties. The idea is to do it in a budget-neutral way, and in this era it makes sense that the pie can't or shouldn't get any bigger. The proceduralists are arguing that if primary care needs to get paid more, that's fine, but find more money somewhere else. Which is a stupid and wrong argument.

Ted said...

Which opens the question:
How much _should_ a doctor make?

JimII said...

Well, I'm in no position to know that "the primary care docs are terribly underpaid and the specialists are terribly overpaid." But as Ted points out this necessarily raises the question how much should a doctor be paid. It seems that the uninformed could decide that the primary care doctors are paid a fine amount of money and specialists are terribly, terribly overpaid.

In any case, it would be an ugly topic to be considered in the public discourse. At least for you medical types. I'm sure lawyers will end up doing fine Thenardier style.

ERP said...

Somehow I don't think a 5% decrease in proceduralists payments would hurt that bad - especially if it were tied into some malpractise reform or cap since that seems to be their main reason for demanding higher payments for procedures.

Ted said...

Given the frequent railing about malpractice law, I think a lot of physicians would be willing to take a pay cut if med-mal tort reform were tied to it...

JimII said...

Given the frequent railing about malpractice law, I think a lot of physicians would be willing to take a pay cut if med-mal tort reform were tied to it...When not doing political law, I do commercial litigation defense. It is certainly true in my business, and I understand equally true in med-mal, that the biggest culprits are those who raise lots of frivolous law suits rather than so much the single giant verdict law suit. Unfortunately, tort reform seems to focused on preventing another John Edwards rather than another Golberg & Osborn.