Tonight, the House of Representatives passed the Senate health care reform bill, by a vote of 219 to 212. President Obama plans to sign the bill into law shortly.
While the Houseâs vote today sends the Senate health care reform bill directly to the White House to be signed into law, they have also sent the reconciliation package to the Senate. This package aims to retroactively change parts of the Senate bill to the liking of the House.
Senate leadership pledged that they would address House concerns through budget reconciliation, but with the Easter/Passover recess approaching and Senate Republicans pledging to fight, there remain questions about if or when the reconciliation package will be considered. Should the Senate Democrats follow through on their pledge; the AAOS will continue to push for the changes we have outlined since the Senate bill was first announced. As stated previously by the AAOS, we opposed the flawed Senate bill for some of the following reasons:
⢠An unaccountable Medicare Advisory Board. This Board would grant an unelected body authority to make policy and payment decisions about the Medicare program without sufficient checks, balances, and the oversight from elected Members of Congress that Americans deserve and expect from their government.
⢠No reform of the Medicare flawed physician reimbursement formula. With practice costs continuing to rise in the face of devastating cuts due to the Medicare Sustainable Growth Rate (SGR) formula, many physicians can no longer afford to stay in practice or to accept Medicare patients. By not repealing and replacing the flawed physician payment formula, this legislation severely threatens seniorsâ ability to access timely and appropriate care from their physicians.
⢠Mandatory participation in the flawed Physician Quality Reporting Initiative (PQRI). This program is still experiencing significant problems in providing accurate, actionable feedback to physicians and has not demonstrated an ability to improve the quality of care provided to patients. Furthermore, a mandatory and punitive approach would increase the already high cost of defensive medicine.
⢠Direct access to physical therapists. The CMS Innovation Center would conduct a demonstration project that would allow physical therapists direct access to Medicare patients. Current Medicare law requires a physician to authorize the type, amount and duration of physical therapy and other health care services furnished to a patient. These laws protect patients and ensure that appropriate, timely treatment is given by the most qualified provider, a physician.
⢠Restricted physician hospital ownership. We believe that physician-owned hospitals are an important component of our health care delivery system and strongly oppose the language included in the bill that would prevent physicians from owning hospitals in this country in the future. Physician owners in physician-owned hospitals have greater control over the facility and the quality and efficiency of care (e.g., scheduling of surgeries, surgical equipment, staffing, etc.) which lead to higher quality patient care. Furthermore, these facilities tend to have greater patient satisfaction, reduced costs, and lower infection rates. We believe it is a disservice to our patients to eliminate these successful partnerships.
⢠Lack of adequate medical liability reform. We believe that meaningful medical liability reform at the federal level and/or constitutionally sustainable state medical liability reforms are a necessary component of any viable health care reform proposal. Absent liability reforms, billions of dollars will continue to be wasted on defensive medicine, driving up the cost of health insurance.
Todayâs vote is clearly not what we had hoped for, but your many calls to Congress and your continued engagement are appreciated and are encouraging to all of us. We will continue to fight for changes that address our concerns and improve health care for our patients during the budget reconciliation process.
In the coming days and weeks, the AAOS will continue to keep you updated.
Sincerely,
John J. Callaghan, MD
AAOS President
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