Dr. Gil Lederman talks about congress' decision to pass the physician payment bill. Click on this presentation to find more

1. The Breakdown- Congress' Bill to Fix
Medicare Physician Payment

2. In a rare show of bipartisan lawmaking, Congress has passed a bill to fix physician payments
under Medicare. This bill - The Medicare Access and CHIP Reauthorization Act of 2015 - was
indeed passed by overwhelming margins in both houses: 392-37 in the House of Representatives
and 92-8 in the Senate, respectively. President Obama applauded both chambers and parties for
their uncommon act of governance. Renee Ellmers, Republican Representative from North
Carolina, put it, "I would say to the American people, don't look now but we are actually
governing."
In a frequent example of Washington absurdity, this fix is actually a solution to a past "fix"
dubbed the doc fix which was passed almost two decades ago in an attempt to help balance the
budget. That Congress worked to establish a formula - named the Sustainable Growth Rate - that
was tied to the rate of economic growth and would be used to pay Medicare doctors. This
formula quickly became obsolete as the cost of health care rapidly outstripped both inflation and
the rate of economic growth. At this point, the Sustainable Growth Rate was poised to harshly
slash payments to doctors treating Medicare patients. This in turn would threaten to push doctors
away from treating those patients at all.
Thus, year after year, Congress came together right before those cuts kicked in and constantly
passed short term bills that would postpone them. This is a frequent Washington example of the
term, "kicking the can down the road." Now, Congress has finally picked the can up. This $214
billion act of bipartisan governance will permanently replace the doc fix with a gradual raise on
payments to Medicare physicians. In a nod toward efficiency, payments will be tied to the
quality of the physicians' care rather than the sheer quantity of care they provide. These "value
based" payments promise to do more than save taxpayer money, moreso improving the quality of
health care overall by incentivizing exceptional treatment.
The federal bill will also extend CHIP - the Children's Health Insurance Program - for an
additional two years. This costs will be partially offset with $70 billion worth of changes to the
structure of Medicare. Namely, wealthy seniors - or rather seniors with high incomes - will be
required to pay more into Medicare. Moreover, there will be cuts in Medigap plans.

3. This show of bipartisanship is not promised to last, however, as the following months bring on
presidential politics. Notably, presidential candidates Senator Ted Cruz and Senator Marco
Rubio both voted against the bill.
Dr. Gil Lederman is NY based, and one of America’s finest doctors.