Reid Blackwelder, M.D. stated, “We’re dismayed that Congress
sabotaged their own work by linking this legislation to unrelated,
ideological issues – particularly in light of the nearly universal
opposition to such action from patients, insurers, and the medical
community.” AMA Immediate Past-President, Ardis Hoven, M.D. of
Kentucky, added, “This was not a failure of physicians or organized
Medicine. This was a failure that must be laid directly at the feet of
our elected members of Congress. This was all about politics, not
about what is important in our country.”
LEARNING WISER APPROACHES
In spite of profound disappointment, physicians must immediately
recover, and once more push the SGR repeal boulder up the legislative mountain. The current formula is an unacceptably unfair
burden on physicians, and ultimately on Medicare patients. Also,
there is real urgency, as the window of lowered cost will likely not
be lasting. There remains a very slim hope for action this session, as
our unified medical organizations continues to pursue SGR repeal.4
However, Congress must overcome its partisan, ideological gridlock,
and begin serving patients over politics. Important lessons should
be learned from the recent bitter experience. Physicians must lead
by pressing Congress to reach consensus on funding sources that
are not ideologically divisive. In future health care legislation, we
must insist that funding sources be agreed upon at the beginning
of the process, rather than left to the last-minute. Strong ideological
differences in Congress are unlikely to disappear in the foreseeable
future, so wisdom should instruct us to firmly insist upon non-ideologic solutions from the onset that are acceptable to both parties.
HOLD PATIENTS ABOVE POLITICS
In addition to strongly supporting the efforts of the AMA and
other organized medicine groups, physicians should work intensely
within their chosen political parties to emphatically and repeatedly
prioritize SGR repeal. The fundraisers and campaign activities of
the upcoming months present opportunities to seize this initiative
and make recipients of our political support clearly realize that
we hold patient care foremost, that SGR repeal is essential to that
principle in Medicare service, and that these are our highest legislative priorities. Thus, our patient advocacy will provide the lifting
power to climb over steep partisan politics and finally reach the
summit of SGR repeal.
REFERENCES
1. Tobin GR. Eight-six the SGR. Louisville Med 2009;57(7):20-21.
2. American College of Surgeons. SGR opposition letter to Congress. Available at www.facs.org/ahp/medicare/sgr-patch-opposition-letter0314.pdf. Accessed April 8, 2014.
3. Hedstrom J. The SGR repeal: How bad politics ruined sound
policy. Bull Am Coll Surg 2014;99(6):9-12.
4. As this issue went to press, Congress left on summer recess
choosing to ignore SGR repeal. LM
Note: Dr. Tobin is a professor at the University of Louisville School
of Medicine, Department of Surgery, Division of Plastic and Reconstructive Surgery. He practices with UofL Physicians-Plastic &
Reconstructive Surgery. Dr. Tobin is a member of the Innominate
Society, Louisville’s medical history society.
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