Don't Rush Reform

Florida’s Largest Physician Group Sounds Alarm on Senate Health Care Bill

A stealth provision that would undermine state damage caps

Health Care Overhaul Proposals Comparisons

Letter to AMA President James Rohack, MD, AMA President-Elect Cecil Wilson, MD

What is HR 3590?

HR 3590, the Senate health care system reform bill, is entitled the “Patient Protection and Affordable Care Act.” It is very similar to the bill passed out of the Senate Finance Committee earlier this fall.

What will a “public option” do?

The bill contains a public option, called a community health insurance option, with an opt-out for states not wishing to participate. This public plan would negotiate rates with physicians. In spite of the ability to opt-out, the community health insurance option is flawed and will ultimately limit patient choice and insert the government between the physicians and their patients. This will seriously interfere with health care decisions.

Will health care reform impact Medicare and how seniors receive care?

The bill substantially reduces the growth of Medicare payment rates for most services relative to the growth rate under current law. It creates an Independent Medicare Advisory Board which is required to make reductions in Medicare costs that automatically go into effect unless Congress blocks the recommendations. These cost reductions cannot come from a modification of eligibility or benefits, leaving physicians and others caring for senior citizens to bear the cost reductions. This is unprecedented and unchecked authority that will result in fewer treatment options for vulnerable senior citizens because reimbursements for valuable, life-saving treatments will be reduced.

How will this affect Medicaid patients?

The bill adds approximately 15 million to the Medicaid population and places a significant tax on insurance plans with relatively high premiums. Florida’s Medicaid program must be fixed before it is expanded. It is woefully underfunded now, with Florida physician payment rates ranking among the lowest in the nation. This will result in more Medicaid patients not being able to access the care of a physician, frustrating the patients, threatening their well-being and flooding the emergency rooms which exponentially increases health care costs.

How will HR 3590 affect access to care?

The bill limits access to care by not adequately address the serious, continuing problems with the current Medicare physician payment system. The temporary one-year fix contemplated in the legislation does nothing for a desperately needed long-term solution and compounds the accumulated SGR debt and leaves a payment cut of approximately 28% in place for 2011.

Will HR 3590 put an end to doctors practicing defensive medicine?

The bill does not adequately address medical liability reform. Encouraging states to develop and test alternatives to the current civil litigation structure will not solve the medical liability problem and will not decrease the costs that result from the flawed medico legal system. The Congressional Budget Office recently confirmed that a comprehensive set of tort reforms would reduce the nation’s deficit by $54 billion over 10 years which would help finance expanded health coverage and help contain cost increases.