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May 2015

Medicare ‘Doc Fix’ Finally a Done Deal

Washington Watch


After 17 temporary fixes over the past 11 years, Congress has approved legislation permanently blocking perennial cuts in physicians’ Medicare fees. In a rare show of genuine bipartisanship, the House and Senate both overwhelmingly passed the bill. It should become easier for doctors to make a living while taking Medicare patients and help seniors keep their doctors who accept Medicare.


In a 1997 budget agreement, Congress set up a formula, known as the Sustainable Growth Rate, or the SGR, which called for annual cuts in Medicare physician payments. But every time the cuts have been scheduled, heavy lobbying by doctors and health groups, and seniors associations have pushed Congress to come through with some short-term patches, known on Capitol Hill as “the doc fix.”


Without a change in the law, doctors came within hours of doctors facing dramatically smaller paychecks from Medicare – a 21 percent cut in Medicare fees, which was scheduled to go into effect April 1, but had been postponed to allow Congress to finish with the pending legislation. What it will mean to seniors is increased premiums for those with incomes of more than $85,000 a year, starting in 2018.


What is also at stake for doctors is bigger than a simple short-term or long-term fix: without a deal, doctors fear their pay will continue to be reduced or not grow sufficiently. Many doctors have threatened to stop treating Medicare patients altogether. The new payment formula would help doctors get out from under the constant threat of payment cuts while shifting to a new payment system based on quality, value and accountability.


A Final Stop to Repeating Uncertainty: The New Deal


The House voted 392-37 approving legislation that would stop the cuts, and the Senate voted 92-8. Some of the most conservative Senate Republicans were unhappy about the House’s failure to fully pay for the cost of the doc fix.


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Sweetness of Motherhood


Whether you’ve mothered your own child, a friend’s, or a beloved pet, you know that motherhood not only is flavored sweet, but also savory, sour, and bitter. “Along with the sunshine, there’s got to be a little rain sometime,” sang country music star Lynn Anderson in the 1970 hit “(I Never Promised You) a Rose Garden.”


My daughter Molly called the other day, choking back tears. I could hear her 2-year-old daughter Carly screeching in the background – refusing to succumb to an afternoon nap. As I tried to calm my 33-year-old baby from 100 miles away, Carly’s screaming (naturally) awakened my infant grandson. Molly had no choice but to turn from being consoled to consoling.


When Carly was a newborn, my husband and I came to help out for a few days. Newborns do practically nothing but sleep, and yet she managed to run six adults ragged – our daughter’s in-laws included. The hardest part for me was not offering all my hard-earned wisdom. Like many new moms, she had read a library full of books and didn’t solicit generation-old advice. I even managed an Academy award deserving response in this exchange:


Me: “Would you like me to change Carly’s diaper?”


Molly: “Do you know how?”


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