Ev­ery­body is an­gry in gov­ern­ment and health­care

In to­day’s po­lit­i­cal land­scape, anger reigns supreme across the coun­try

Modern Healthcare - - News - NEIL MCLAUGH­LIN Manag­ing Ed­i­tor

If you like be­ing an­gry, th­ese are the best of times.

Take Repub­li­can Sen. Jim Bun­ning of Ken­tucky, for ex­am­ple (or please). He got worked up in the last week or so over the fed­eral deficit. An emer­gency spending bill mov­ing through the Se­nate aroused the solon’s ire. He used one of those dila­tory Se­nate rules we have been hear­ing about so much lately to ef­fec­tively fil­i­buster the mea­sure. Bun­ning de­manded that the gov­ern­ment should pay for the leg­is­la­tion up­front rather than re­sort to the tra­di­tional fis­cal leg­erde­main.

This par­tic­u­lar leg­isla­tive pack­age con­tained about $10 bil­lion for an ex­ten­sion of job­less ben­e­fits, pay for high­way work­ers, satel­lite TV for ru­ral ar­eas—as well as CO­BRA ben­e­fits and a patch to pre­vent a 21.2% Medi­care pay­ment cut to physi­cians un­der the sus­tain­able growth-rate for­mula.

Bun­ning’s action per­turbed a few peo­ple. Be­yond those whose job­less ben­e­fits were im­per­iled, there were the 2,000 work­ers at the U.S. Trans­porta­tion Depart­ment who were fur­loughed. And then there were the doc­tors. We’ll get back to them in a mo­ment.

The leg­isla­tive block­ade ticked off much of the Se­nate, which isn’t en­joy­ing the high­est pub­lic-ap­proval rat­ings th­ese days. Democrats cried in out­rage at Bun­ning’s ma­neu­ver, but they weren’t in too much of a rush to force a clo­ture vote since the se­na­tor’s an­tics cre­ated a po­lit­i­cal ad­van­tage for them. Some Repub­li­cans got hot un­der the col­lar, too, as they watched the spec­ta­cle of a GOP law­maker hurt­ing job­less peo­ple, trans­porta­tion work­ers and physi­cians ahead of midterm elec­tions. Se­na­tors from both sides must have won­dered whether Bun­ning, a Hall of Fame pitcher, had some­how beaned him­self too many times dur­ing his ma­jor league ca­reer.

Maybe Bun­ning was just an­gry that some of his GOP col­leagues, alarmed by his er­ratic be­hav­ior over the years, had pres­sured him into a pend­ing re­tire­ment. He sud­denly de­vel­oped a han­ker­ing for fis­cal re­spon­si­bil­ity when it came on the backs of work­ers and doc­tors.

In the end, af­ter much plead­ing by Democrats and the urg­ing of a few Repub­li­cans, Bun­ning ca­pit­u­lated. A vote was held, and the mea­sure passed 78-19 af­ter an amend­ment by Bun­ning to off­set the spending failed with only 43 votes in sup­port. Physi­cians were fu­ri­ous in the days lead­ing up to the fi­nal res­o­lu­tion. Med­i­cal groups is­sued state­ments ex­press­ing in­dig­na­tion over the lack of an SGR fix. This mag­a­zine re­ceived many irate mes­sages us­ing words such as “ou­tra­geous,” “un­con­scionable” and “ar­ro­gant.”

The doc­tors are right to be an­gry. Congress should have per­ma­nently fixed the flawed SGR for­mula years ago in­stead of do­ing what it usu­ally does—kick­ing the prob­lem down the road, let­ting some­body else make painful po­lit­i­cal choices in the fu­ture. Congress ought to in­cor­po­rate a pay­ment change as part of health­care re­form—if it can ever muster the courage to do some­thing fi­nal on that is­sue.

And there’s some­thing to anger a big por­tion of Amer­ica. Since the Great Re­ces­sion be­gan, nearly 8 mil­lion jobs have been lost. And be­cause health­care cov­er­age is so tied to em­ploy­ment in this coun­try, even more peo­ple are ei­ther go­ing unin­sured or go­ing on Med­i­caid or other gov­ern­ment pro­grams to get by.

It would be nice if physi­cians, hos­pi­tals and other providers could work up a lit­tle rage not just over their own in­comes, but also over the plight of mil­lions of unin­sured Amer­i­cans. Maybe they could visit Capi­tol Hill or write a few let­ters. Maybe they could de­mand that their law­mak­ers pro­vide their pa­tients with a ra­tio­nal and hu­mane health­care sys­tem—you know, like ev­ery other de­vel­oped coun­try.

Now there’s some­thing to get an­gry about it.

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