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Wednesday, January 31st 2007

Aren't We On The Same Team?

The Governator Was In The Hospital To Get His Horn Transplanted…

California GOP legislators have submitted a counter proposal to Schwarzenegger’s health plan.

Schwarzenegger’s plan would…expand government spending, but he would mandate that all but the smallest employers provide coverage or pay into a state pool that would offer subsidized policies.

The governor’s plan would also impose a tax on the profits of hospitals and doctors in exchange for higher reimbursements on state-funded services.

Obviously that second paragraph has caused some concern for health care providers. Of course the Republican (or the true Republican) plan has little chance of gaining any traction in a state dominated by Dems. However, the article raises some hopeful news about the proposed provider tax,

While the plan is not likely to gain much traction in the Democratically controlled Legislature, minority leaders made it clear they will not support a new tax to pay for more health care — a critical position because Republican votes would be needed to achieve the two-thirds majority for passage of a tax.

“We do not believe we need one,” said Sen. Dave Cox, R-Fair Oaks (Sacramento County). “I can’t imagine we would be voting for it.”

While I have endorsed pay-or-play mandates as a part of any compromise health care reform, how can any physician or physician in training endorse a provider tax?

One of the greatest concerns about health care in this country should be the death of primary care, which is largely tied to reimbursement issues. PCPs have some of the highest overhead-to-earning ratios and since the tax would be on gross practice revenues this would be a terrible thing for the earning power of primary care (which, as said, is already in semi-bad shape).