Saturday, March 21, 2015

Kill the SGR

One of the best examples of misnomers in government policy is the sustainable growth rate (SGR) formula that's supposed to automatically adjust Medicare physician compensation (mainly downward) each year.

The formula is flawed and so every year, there is an incredible effort by doctors and people in Congress to postpone its effect.  This creates the usual Washington work-around, in that the savings that would otherwise arise from the SGR disappear, and, under Congressional rules, the money has to be made up elsewhere.  That offset never really happens, but a postponement always takes place to avoid the disaster of reducing doctors' compensation.  Sometimes the "patch" lasts a year, sometime just a few weeks while Congress kicks the can down the road.

Well now, there is a bipartisan (yes, bipartisan!) effort to repeal the damn thing.  The AMA is on the case, sending out a gazillion emails to possible supporters. The House is expected to vote on the proposal next week, before the March 31 expiration date of the current patch.

I don't know whether the proposed solution is the best possible, but it is not time to let the perfect be the enemy of the good:  It is time to eliminate this odd provision in the law.


Dave said...

I may be overly cynical (time will tell) but the SGR is considerably more valuable to Congress as an issue to wring money from organized medicine than a problem to actually solve. I predict yet another 1 year fix.

Barry Carol said...

I hope the so-called permanent doc fix passes this time even if most of the cost, as scored by the CBO, is not paid for with offsets elsewhere. If we can finally put this issue to bed, perhaps tort reform will move up to the top of the physician lobby’s priority list. As I understand it, when the ACA was being debated, their top priority was the doc fix.