Allow Me To Explain... Healthcare Reform in the US is Doomed

I had some people comment on my last rant about health care for all in this country. What most people DO NOT understand is that the current policy proposal is much like the system that Massachusetts has been running for years. And, contrary to the opinions from those who feel like giving free medicine to all, it is not working. And it is harming the welfare of doctors, specifically those in specialty fields. And it is creating worse health care.

Read this and then I'll happily debate with you over the current proposal. I'm all for healthcare reform. I really am. But I'm not for agreeing with, "oh yea, let's cover everyone with some extra taxes and cost cutting measures". Why don't we actually solve the problems that exist rather than throw an expensive band aid at it?.


From the ACC:

July 8, 2009

If you don't read another edition of this publication, read this one. Then read it again and get ready to join the ACC's fight for the viability of your practice! CMS late last week proposed mind-boggling cuts to cardiology that could be 30 percent or higher beginning in 2010. Taken together with the payment cuts cardiology already has experienced, this wrongheaded proposal represents a real threat to your practice and to the patients you serve.

Let's break down the horrible numbers. The proposed rule slashes Medicare payments by more than 11 percent for the average cardiology practice as a result of a badly managed practice expense survey. Out of thousands of cardiology practices solicited this survey is based on input from approximately 50. Somehow this small sample size showed that CV practices have experienced a 30 percent reduction in practice costs.

Does that match up to the numbers in your practice? Of course not. This survey has no credibility and CMS chose to disregard the standards it previously put in place to ensure the quality of practice expense data. We believe this is a significant departure from previous policy and may be a violation of the law. It is ironic that the agency that purports to support an evidence-based approach to medicine is making major decisions based on shoddy and incomplete data.

It gets worse! As if the 11 percent were not bad enough, most of the core cardiology services face cuts ranging from 20 to 40 percent. Add in the regularly scheduled SGR cuts of more than 20 percent and practices could see possible payment cuts ranging from 25 to almost 50 percent.

This is not what we meant by putting quality first. The timing couldn't be worse. Just as we're moving forward with real proposals for health care reform that would improve quality, reduce waste, slow spending and improve the viability of CV practices, along comes this CMS hatchet job. Arbitrary price controls do not equal reform and will only lead to greater disparities in health care.

That's the bad news. The good news is that this proposal is subject to revision. Your ACC is fighting this change at all levels through CMS, Congress and the Administration. ACC President Fred Bove, and your elected officers and Washington-based staff are all over this crisis on your behalf.

Working closely with our partner cardiovascular societies we are developing a detailed response to CMS and working the halls of Congress to bring political pressure to bear on the agency. We are reaching out beyond cardiology to engage other specialties like oncology that also face daunting cuts that will inevitably impact patient diagnosis and treatment. On the regulatory side, ACC staff is working closely with the Advocacy Steering Committee and the CV RUC to prepare a substantive analysis and response to this proposed rule. We anticipated this action from CMS and have identified technical expert consultants who can assist us with our analysis and help propose alternatives.

We have been rocked by this proposal and now it's time to roll! Here are four key ways you can get involved:

* The ACC has launched a grassroots campaign to get Congress involved. Go to www.acc.org/can and send a letter to your members of Congress explaining in detail how 20 to 40 percent cuts will impact your ability to practice medicine.
* Take part in a video campaign that can be shared with members of Congress, regulatory officials and the public. Upload a 30-40 second video about the impacts of large-scale cuts on your ability to provide patients with the right care at the right time. Email Molly Nichelson at mnichels@acc.org to have it posted for you on ACC Advocacy's YouTube" site. Don't own a video camera? Submit your story via the ACC's online forum, "The Lewin Report."
* Take part in the ACC's "Cut the Cuts Roadshow" and volunteer to give your own or facilitate an ACC-taped presentation on the implications of the cuts on cardiology to your hospital or practice group. Email qualityfirst@acc.org for more information
* Get involved with your local Chapter's efforts: this could include volunteering your practice to host a "Cardiologist for a Day" event, writing op-eds and more. Go to www.acc.org/chapters for contact information or email qualityfirst@acc.org.