As Democrats work to prevent a 21% pay cut to doctors treating Medicare patients, they may find an unlikely ally in hard-nosed libertarian Senate candidate Rand Paul, who just won an upset victory in the GOP Kentucky primary. The cut is the fault of the so-called sustainable growth rate formula (SGR), which Congress created in 1997 to match increases in physician payments under Medicare Part B to the growth in the GDP. SGR has threatened to cut Medicare reimbursements for nearly a decade and Congress has been preventing any cuts in payment without fixing the problem permanently. Each year the problem just piles onto itself – so what was a 2% cut back in 2002 has mushroomed exponentially into a 21% cut due June 1st.
In November, the House voted to replace the current SGR with a formula that would give doctors an annual payment increase equal to 1% more than the growth in the GDP (2% more for primary and preventive care physicians). But Democrats, concerned about that proposal’s high price tag (and worried that Republicans would add the cost of the proposal to price tag of the health care law), are now proposing a multi-year patch that would prevent the cuts from going into effect but do nothing to address the underlining problem.
Repealing the SGR would cost about $250 billion, a five-year fix “is estimated to cost $88.5 billion” and Paul, who as an ophthalmologist has an average salary of some $256,320, supports the more expensive permanent fix. From the WSJ:
In fact, Paul — who says 50% of his patients are on Medicare — wants to end cuts to physician payments under a program now in place called the sustained growth rate, or SGR. “Physicians should be allowed to make a comfortable living,” he told a gathering of neighbors in the back yard of Chris and Linda Wakild, just behind the 10th hole of a golf course.
Paul’s sentiment is shared by the American Medical Association and other doctors groups, but it’s particularly surprising for a candidate who rallies against “out of control” government spending and warns that the country could experience a Greek-like debt crisis. “I’m concerned that we could have a debt crisis in this country, and we’ve got to look at the entire budget,” Paul told CNN’s John King. “We either downsize departments, maybe eliminate some departments, maybe privatize some departments, or maybe we can’t do anything to a department. But we look at every department, every expenditure, and we find out how it can be reduced.” Apparently, the same does not apply for his own pocketbook.
Senate Democrats are expected to move the “scaled back” fix to the floor tomorrow and attract the support of Sens. Susan Collins (R-ME) and George Voinovich (R-OH).