A year ago, Doctor Pundit highlighted the perennially contentious matter of Medicare payments to physicians. At that time, President Obama was about to realize the full-fledged partisan war to be waged on his ideas of healthcare reform. So far, in 2010, most of the president’s posturing on the issue has been to delay — on an apparent month by month basis — the presumptive rate in cuts in physician reimbursements that now stands at 21 percent. Obama’s rhetoric has largely been one of terming any Congressional effort to block reform in this area as “obstructionist” and “preventing any action” on payment “reform”.

Referring to the Senate, which has yet to act upon the House’s approval of yet another payment cut delay; Obama apparently echoes the anger being felt by many physicians if cuts (due to begin processing later this month) are realized.

We cannot allow this to happen. We have to fix this problem so that our doctors can get paid for the life-saving services they provide and keep their doors open. We have to fix this problem to keep the promise of Medicare for our seniors so that they get the health care they deserve. So I urge Republicans in the Senate to at least allow a majority of Senators and Congressmen to stop this pay cut. I urge them to stand with America’s seniors and America’s doctors.

A year ago, MedPac took up this issue with a warning.

[T]he federal government must give doctors and health-care facilities incentives to rein in costs in providing care for the elderly and disabled. Further, their report goes on to say, “Costs are high and increasing at an unsustainable rate in part because the healthcare delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, and quality of care is often poor.”

While Obama’s immediate goals with Medicare payments to physicians are clear and are generally supported by physicians, what is murkier is how legislation would have to look to end such budgetary measures that involve cuts to healthcare delivery via CMS. Time will tell^[1] but the question is: how much of it do Obama and both chambers of Congress have by the November midterms?

1. Additional measures would possibly include legislation to “reform” the SGR formula which projects and computes such payments, along with other actuarial measures. [↩]

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