The Economic Stimulus Bill – Could this be Health Care’s First Big Win of 2009?

So far, the hot issue in Washington is the Economic Stimulus bill that President Obama has requested.  H.R. 1, the American Recovery and Reinvestment Act of 2009, passed the House at the end of January and passed the Senate a few days ago in amended form.  The healthcare provisions were similar in both versions of the bill, but differed slightly in certain areas.  The HIT portions created quite a buzz in the analysis arena with reports spreading misinformation on how HIT would be implemented.  According to some of these reports, for example, a federal system would be created to electronically track treatments and monitor compliance of federal treatment standards.  This is simply not true.  Neither version of the bill included the formation of such an entity.  Other misconceptions included the idea that penalties for not adopting HIT would be associated with treatment decision made by the physician and that a single bureaucracy would be created to determine if treatments are appropriate or cost effective.

 Follow the read links to see a detailed summary of healthcare provisions in the two packages as well as a more detailed clarification of recent mischaracterizations of H.R. 1.

 Read: Comparison of Healthcare Aspects in House and Senate Versions

 Read: Clarification of HIT in HR 1

TMA Release "Doctor's Orders" - Preparation for the 2009 Texas Legislature

TMA Releases "Doctor's Orders"

As we prepare for the 81st Texas Legislature, we study the potential hot button issues to predict what organized medicine will be fighting for in 2009. According to "Doctors Orders: TMA's Prescription for a Healthy Texas," we are girding our loins for some difficult battles. As always, we will be lobbying for health insurance reform by promoting a code of conduct standard by which insurance companies must adhere, out of network accountability, and the establishment of a regulation system for PPOs. To address our looming physician shortage and increase access to care for all Texans, we will supporting legislation on properly funding our loan repayment program, funding for graduate medical education, fixing the Medicaid payment system, and protecting medical liability reforms. We are aiming to address public health issues as well, targeting the obesity epidemic and promoting smoke free ordinances, cancer prevention and detection methods, and immunizations. Corporate practice of medicine laws could also be on the chopping block which could severely limit the autonomy of the physician and have severe implications on the quality of care.

For up to date information on the session that affects you, keep your browsers pointed to the DCMS News Feed.

Read:
Doctor's Orders: TMA's Prescription for a Health Texas

Hello Win Column!! HR 6331 Enacted

As predicted, President Bush vetoed HR 6331 after the bill passed the House and squeaked by the Senate. But Congress put its proverbial foot down and voted again to support physicians, patients, and medicine as a whole.

The House tally: 383-41
The Senate tally: 70-26

This is only the third time Congress has been able to override a Bush veto. Obviously, those against the bill cite cuts to Medicare Advantage plans as the reason the bill should not be enacted.

Bush wrote in his veto message: "I support the primary objective of this legislation, to forestall reductions in physician payments. Yet taking choices away from seniors to pay physicians is wrong."

Democrats (and most of the Republicans in Congress!) argue that while this "limits" choices of plan for Medicare patients, it increases access to care for these patients. Physicians threatened to close their practice to Medicare patients if the cut was not fixed.

So there it is folks, we won. Granted, there are plenty more battles to be fought, but we can breath a little at least for a few days.

Now what happens? Stay tuned!

HR 6331 - Can We Avoid the Veto?

As I am sure you are aware, the Senate passed a cloture vote on HR 6331 by a margin of 69 to 30 with Senators Hutchison and Cornyn voting YES! Currently we are waiting for President Bush to veto the bill (as he has promised to do on many occasions) or to sign it into law. Bush has 10 days to make a decision; if no action has been taken in 10 days, the bill becomes law. The AMA expects a veto on Saturday.

If the President does veto the bill, Congress will have a chance to override. For this to happen, the Senate and the House will need to pass the override with a 2/3 (two-thirds) majority. This is entirely possible! HR 6331 passed in the House by a count of 355-30 which well exceeds the necessary margin. The squeaker will be the Senate, which passed the bill with a tally of 69 Ayes and 30 Nays, only 2 votes in excess of the 2/3 majority needed. The good news, though, is that Senators Hutchison and Cornyn have promised to support the override. Unfortunately, we never know how anyone will vote until the votes are in.

The success (read: relative success) of this bill is somewhat surprising for a number of reasons. First, the Senate couldn't pass a similar cloture vote before the holiday weekend. Second, republican Representatives and Senators voted in favor of this bill dispite threats from the President to veto and the fact that it takes funding away from Medicare Advantage plans (the private side of Medicare). Third, similar bills have been proposed with no success. We were even poised to see a bill introduced in the Senate combining Grassley's and Baucus' bills promoting a "both sides of the fence" fix.

The momentum has been pushed into medicine's favor and that can only be attributed to the drive and constant pressure from the medical community. The "never stop fighting" attitude has begun to accompish its goal of protecting the industry, the patient, and the physician. Keep up the strong work, we only have a few more hurdles in this race. Unfortunately, we have way too many races ahead of us before we reach the podium.