Congress re­turns to lots of un­fin­ished busi­ness, in­clud­ing doc-pay fix

Congress has plenty of un­fin­ished busi­ness, in­clud­ing new at­tempt at doc-pay fix

Modern Healthcare - - MODERN HEALTHCARE - DAVID MAY As­sis­tant Man­ag­ing Ed­i­tor/fea­tures

Mem­bers of Congress, who fi­nally re­turned from hol­i­day break last week, will need to quickly re­turn to some un­fin­ished busi­ness—the is­sues squeezed in­side the can they kicked down the road once again just be­fore Christ­mas. It’s a new year and now a new crit­i­cal dead­line looms at the end of Fe­bru­ary. Mat­ters to be re­vis­ited in­clude any ex­ten­sion to the So­cial Se­cu­rity pay­roll tax hol­i­day, unem­ploy­ment com­pen­sa­tion and the on­go­ing pur­suit of the doc-pay­ment fix. So far, none of the so­lu­tions en­acted for the sus­tain­able growth-rate for­mula have fixed any­thing. It’s just been one patch on top of an­other. Can it be any dif­fer­ent this time?

Based on the de­bate late last year over the SGR and a ful­lyear re­duc­tion in the pay­roll tax, the ul­ti­mate game plan seemed to draw some bi­par­ti­san sup­port. It was just a mat­ter of how to make it into the end zone.

To help pay for some of these pro­vi­sions, con­gres­sional Democrats and the White House have fa­vored a tax sur­charge on high-in­come Amer­i­cans, mak­ing a case for fair­ness in Amer­i­cans’ tax bur­den, es­pe­cially for the mid­dle class. Repub­li­cans have coun­tered that with the econ­omy still tee­ter­ing, it’s a lousy time to raise taxes for any­body, con­tend­ing that tax­ing high in­comes would be a strong dis­in­cen­tive for the na­tion’s “job creators”—namely small-busi­ness own­ers.

All sides score some valid points in their ar­gu­ments, but there should be no dis­agree­ment over who the real job creators are. They’re all of us. Ev­ery­one read­ing these para­graphs is a job cre­ator. With­out all of us as buy­ers, sell­ers, con­sumers and—in this in­dus­try’s sphere—pa­tients— few jobs could be cre­ated. Small busi­nesses might do the heavy lift­ing when it comes to the process of hir­ing, but only be­cause we en­able them. Con­sumers are the true fi­nanciers. It’s just that right now our per­sonal and na­tional bal­ance sheets are so out of whack.

Law­mak­ers must keep try­ing to get this one right. We cer­tainly need tax fair­ness—and sim­pli­fi­ca­tion. We also still re­quire a strong safety net for the long-term un­em­ployed as well as the le­gions of Amer­i­cans lack­ing health in­sur­ance. At the same time, we need lead­er­ship to ad­dress our bur­geon­ing na­tional debt. Lastly, but cer­tainly not least, all sec­tors need to recom­mit to mak­ing health­care truly af­ford­able. Are we near­ing a tip­ping point here?

On the topic of an­other pos­si­ble tip­ping point—this one in­volv­ing how we’re tip­ping the scales—there was some po­ten­tially en­cour­ag­ing news last week. Ac­cord­ing to new data from the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, Amer­i­cans might fi­nally be mak­ing progress, al­beit in­cre­men­tal, in the bat­tle against obe­sity.

The study shows that af­ter decades of rapid growth in per­cent­ages of the pop­u­la­tion con­sid­ered over­weight and obese, growth rates have slowed sig­nif­i­cantly in the past decade and in some cases have lev­eled off. For men, the obe­sity rate from roughly 1980 to 1994 jumped 7.9 per­cent­age points; a decade later it rose an­other 7.1 points. For women dur­ing the same pe­ri­ods, the num­bers were even higher, ris­ing 8.9 and 8.1 per­cent­age points, re­spec­tively. In the most re­cent study pe­riod, through 2008, the rate in­creased 4.7 per­cent­age points for men and just 2.1 per­cent­age points for women, or sta­tis­ti­cally flat.

The study’s au­thors re­mind us that roughly one-third of men and women are still obese, which rep­re­sents dis­mal num­bers. How­ever, some ex­perts are adding a pos­i­tive spin: Could it be that the na­tion is fi­nally see­ing some re­turn on in­vest­ment from years of in­creased em­pha­sis on wellness plans, health­ier eat­ing, reg­u­lar ex­er­cise and other pre­ven­tion ef­forts?

Here’s hop­ing this is re­ally a trend, not just a blip.

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