Health reform package still needs some improvement

As we enter the new year, we begin where we left off in 2009 -- with work still to do on health system reform. Topping the AMA's "to-do" list in 2010 is improving the final health reform bill as the House and Senate work to reconcile their two versions, and securing permanent repeal of the broken Medicare physician payment formula.

Let me start with Medicare physician payment reform and the confusion expressed by some over its absence in the final Senate legislation. Eliminating the one-year fix originally in the Senate bill produced an immediate upside, as the funds were used to eliminate:

• Budget neutrality adjustments for the primary care bonus.
• Taxes on elective cosmetic surgery and medical procedures.
• Physician enrollment fees for Medicare and Medicaid programs.

Most important, it creates a sense of urgency among senators to act on permanent repeal before the two-month reprieve from the 21% cut ends on March 1. Continuing with short-term fixes is the wrong solution -- and it's one we do not support. It wreaks havoc on physician practices, threatens the stability and security of Medicare access for seniors and military families, and increases the cost of permanently repealing the Medicare physician payment formula.

Only permanent repeal of the flawed Medicare physician payment formula will allow the problem to be solved permanently in a fiscally responsible way that respects both physicians and patients. Your AMA leadership has shared this with Senate and House leadership.

We now have a short window of opportunity for the Senate to take similar action to the House. We are calling on the Senate to repeal the broken Medicare physician payment formula and replace it with one that better reflects the cost of providing 21st-century medical care.

We are mobilizing state and national specialty medical societies in support of this initiative, but your voice as an individual physician is critical. Please visit the AMA's health system reform Web site to see where your senators stand on this critical issue and reach out to them (www.hsreform.org).

As we work together to repeal the broken Medicare physician payment formula, the AMA continues to work closely with House and Senate leadership and White House officials to secure important changes in the final reform bill to more closely align it with our guiding principles.

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