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Friday, October 23rd 2009

SGR Fix Fails

The Sustainable Growth Rate is a Medicare formula under which when Medicare goals over annual budget (virtually guaranteed every year) physicians reimbursements are automatically reduced the next fiscal year to bring Medicare expenditures back in line. In 2010 physician fees are to be cut 21.5% across the board under the SGR formula.

Every year, with significant prodding, Congress forestalls the cuts due to take place under the SGR formula. But they do it merely on a year to year basis.

Proposals to scrap the SGR formula have come and gone, without success, through the Congress under Republican leadership.

Last Wednesday, perhaps the most promising and realistic attempt to do away with the SGR to come up in years was put before the Senate for a cloture vote. It failed.

“In the Senate’s first vote on health care spending this year, a bipartisan majority rejected the Democrat leadership’s attempt to add another quarter trillion dollars to the national credit card without any plan to pay for it,” Mr. McConnell said in a statement. “With a record deficit and a ballooning national debt, the American people are saying enough is enough. Today’s vote shows that this message is finally starting to get through to Congress. Hopefully it’s a sign of things to come in the health care debate ahead.”

In case you’re wondering here are the Senators who let down the physician community:

Sen. Lamar Alexander [R, TN]
Sen. John Barrasso [R, WY]
Sen. Robert Bennett [R, UT]
Sen. Christopher Bond [R, MO]
Sen. Samuel Brownback [R, KS]
Sen. Jim Bunning [R, KY] 2004 Election: $10,000 from AMA
Sen. Richard Burr [R, NC]
Sen. Saxby Chambliss [R, GA] 2008 Election: $7,000 from AMA
Sen. Thomas Coburn [R, OK]
Sen. Thad Cochran [R, MS]
Sen. Susan Collins [R, ME] 2008 Election: $10,000 from AMA
Sen. Bob Corker [R, TN] 2006 Election: $10,000 from AMA
Sen. John Cornyn [R, TX]
Sen. Michael Crapo [R, ID]
Sen. Jim DeMint [R, SC]
Sen. John Ensign [R, NV] 2006 Election: $10,000 from AMA
Sen. Michael Enzi [R, WY]
Sen. Lindsey Graham [R, SC]
Sen. Charles Grassley [R, IA] 2004 Election: $10,000 from AMA
Sen. Judd Gregg [R, NH]
Sen. Orrin Hatch [R, UT]
Sen. Kay Hutchison [R, TX]
Sen. James Inhofe [R, OK]
Sen. John Isakson [R, GA] 2004 Election: $10,000 from AMA
Sen. Mike Johanns [R, NE]
Sen. Jon Kyl [R, AZ] 2006 Election: $10,000 from AMA
Sen. George LeMieux [R, FL]
Sen. Richard Lugar [R, IN]
Sen. John McCain [R, AZ]
Sen. Mitch McConnell [R, KY] 2008 Election: $10,000 from AMA
Sen. Lisa Murkowski [R, AK] 2004 Election: $10,000 from AMA
Sen. James Risch [R, ID]
Sen. Pat Roberts [R, KS]
Sen. Jefferson Sessions [R, AL]
Sen. Richard Shelby [R, AL]
Sen. Olympia Snowe [R, ME]
Sen. John Thune [R, SD]
Sen. David Vitter [R, LA]
Sen. George Voinovich [R, OH]
Sen. Roger Wicker [R, MS]
Sen. Evan Bayh [D, IN]
Sen. Robert Byrd [D, WV]
Sen. Kent Conrad [D, ND]
Sen. Byron Dorgan [D, ND]
Sen. Russell Feingold [D, WI]
Sen. Herbert Kohl [D, WI]
Sen. Claire McCaskill [D, MO]
Sen. Bill Nelson [D, FL]
Sen. Jon Tester [D, MT]
Sen. Mark Warner [D, VA] 2008 Election: $10,000 from AMA
Sen. Jim Webb [D, VA]
Sen. Ron Wyden [D, OR]

Senate Republicans have been overwhelmingly supported by organized medicine over the last decade. Their failure to push through SGR reform while in power was something; this politicization of the issue and en bloc rejection of an SGR fix because it’s a democrat proposal is a kick in the crotch.

The numbers above merely reflect the support of AMPAC and don’t take into account the hundreds of thousands of dollars distributed through state medical association PACs or the lobbying of physician specialty societies. Men like John Kyl and Mitch McConnell have been wholeheartedly supported by organized medicine over the years. Now on the issue most important to physicians they’ve basically betrayed us.

For myself this vote has cost both my Senators my support. Cornyn doesn’t come up again until 2014 but I’m sure I’ll remember this even those years past. Meanwhile, consider this my endorsement of Rick Perry for yet another four years as Governor of Texas.

[zdvideo width=550 height=420 theme=simple2 border=no]http://www.youtube.com/watch?v=s8dcddi_dZI[/zdvideo]

Meanwhile Senators Stabenow, Begich, Casey, Leahy and Udall, all sponsors of the bill, should probably be cheered on by physicians in their states.