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

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

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.