Mt. Vernon Register-News

Opinion

November 7, 2013

Imperfect attempt at reforming doctor pay

Congress may soon vote on a bill changing how, and how much, Medicare pays doctors. That’s a good idea — so long as taxpayers benefit, too.

The impetus for the change is a problem that Congress itself created. In 1997, lawmakers tried to keep down Medicare spending by limiting the growth of doctors’ payments. That was the idea, anyway; every year since 2003, physicians have successfully lobbied Congress to override the pay cuts imposed by the 1997 formula, a move that came to be known as the “doc fix.”

The result is a status quo that serves nobody’s interests. Doctors worry each year about a sudden drop in rates. Congress is forced to look for new money each year to offset the cost of preventing that drop. The federal government must make budget projections that reflect Medicare cuts that are never going to happen. Meanwhile, the purpose of the 1997 law — reining in Medicare spending — remains unmet.

The proposal before Congress would deal most effectively with the first of these problems. It would repeal the 1997 formula, permanently removing the threat of payment reductions.

In their place, the measure would help Medicare catch up with a shift that private health insurers have already started: changing the way doctors are paid, by emphasizing the quality and cost of care over quantity of services.

This makes sense. Under the traditional payment model, doctors and other health-care providers get a fee for each service they provide. That creates a financial incentive to perform tests or procedures that might not be medically necessary, but no comparable inducement for healing patients quickly and efficiently.

Many large private insurers are already starting to abandon the fee-for-service system. By the end of last year, more than half the primary-care providers in WellPoint Inc.’s network worked under some sort of value-based purchasing program; for Humana Inc., that figure was 84 percent.

Text Only
Opinion
  • Close the tax loophole that sends US corporations overseas Since we last overhauled our federal tax code, in 1986, countries around the world have lowered their tax rates, leaving the United States with the highest corporate tax rate in the developed word. At the same time, the system has become full of inef

    July 29, 2014

  • Israel and the U.S.: Whose survival instinct is stronger? There’s something darkly coincidental in the fact that the latest weapon to be deployed against the survival instinct of both Israel and the United States is an alleged “heartlessness” when it comes to children. The people of Israel are castigated in

    July 29, 2014

  • College cost isn't big problem for poor students To judge by this summer’s banner policy proposals, the most important question for higher-education reform right now is giving students easier access to loans. But evidence from Canada suggests those changes won’t address the greater need: Getting mo

    July 29, 2014

  • Ducks, geese a blessing I would like to respond to the “Geese and ducks causing problems in Veterans Park” article that was published in the Mt. Vernon Register-News on July 16, 2014. I must share that I do understand that at times there have been a great number of the Cana

    July 29, 2014

  • Money not always the answer I really have to stop and think sometimes. I challenge my thought processes when I write these columns. I am having a hard time with this one. It appears to me that every time a governmental agency or any of the entities that spend other people’s mon

    July 29, 2014

  • Teachers unions' destructive behavior You can always count on the national teachers unions to behave badly at their annual conventions, and they certainly didn’t let us down this month. In doing so, however, they let down many of their members, along with students who are working hard to

    July 26, 2014

  • Workers of the world, curb your ambitions A group of Democrats introduced legislation this week to protect low-paid shift workers from last-minute changes in their schedules. The idea fits into an intriguing category of economic activism: Not trying to lift low-paid workers out of poverty, n

    July 26, 2014

  • State of the reunion ‘Katy! It’s been so long! How’ve you been?”My God, she’s gained so much weight I didn’t recognize her. It’s a good thing we’re all wearing nametags. I thought it was some distant cousin past due with triplets.“Bob! Long time, no see.”No hair, either.

    July 26, 2014

  • Fear indifference ‘Perhaps the Catholic church would volunteer to pony up some cash for the illegals’ care then? Hmm?”“Pope should stay out of it. Matter of civil laws, not church laws.”“Thinking that the pope should want the illegals to go to Argentina to get better

    July 25, 2014

  • A push for felon voting rights If advocates have their way, voting rights could be a new reality for the nation’s incarcerated.Full voting rights for felons is as hot a topic in Washington as voting rights in reverse pushed by voter-ID-tickled Republicans. But with new legislation

    July 25, 2014

Twitter Updates
Facebook
Stocks