Issue fatigue may be surfacing as a major factor on the doc fix, but there's something even bigger that may drive Congress to get rid of the SGR for good: a fiscal bargain.
That "bargain" refers to Congressional Budget Office (CBO) projections. Under the new Medicare spending plans, CBO estimates that keeping Medicare physician payments at their current level over a 10-year period would cost $138 billion. That's a significant reduction from the $243 billion CBO estimate for the same policy a year ago.
Although uncertainty has haunted the SGR debate for years, an element of optimism has crept into the debate this year because "it's a good deal right now," Frank G. Opelka, MD, FACS, vice chair of the National Quality Forum's consensus standards approval committee, told me the other day.
Healthcare advocates say it's time to strike: get rid of the SGR and put a new plan in its place. When I asked for his view, Jeremy Lazarus, MD, president of the American Medical Association, sent me a statement indicating that there is a definite economic incentive for Congress to act now to repeal the SGR, noting the CBO cost projections.
"The CBO estimates that the cost to repeal the SGR is now less than half the cost projected at this time last year. Congress should act now, before this sale price ends," Lazarus says. "At a time when members of the baby-boom generation are aging into Medicare at an average rate of 10,000 each day, we cannot afford to wait any longer."