After more than a year of debate, it looks like there may be new health reform legislation after Sunday’s House vote on the reconciliation bill. Now, even if the House passes this version of the bill, it can be stalled in the Senate through several parliamentary procedures. But at this point, ultimate passage seems imminent.
So…what’s changed since the Senate passed its bill on Christmas Eve? Kaiser Health News lays out the major differences. For physicians, the only significant addition is that primary care docs get a payment increase. According to Kaiser, “Beginning in 2013 and 2014, the doctors’ payment rates would be on par with Medicare rates, which typically are about 20 percent higher than Medicaid. The goal is to ensure that there will be a sufficient number of doctors willing to care for the millions of additional people who would become eligible for Medicaid under the health care overhaul.”
You may recall that earlier this year President Obama made a big production of a bipartisan health care summit to discuss so-called “Republican ideas” and how to implement them into legislation. Ironically, the significant proposals — eliminating fraud and increasing spending on malpractice reform — never made it into the new bill. If you’d like to read the full text of the reconciliation bill, it’s online here.
In a related story, the New England Journal of Medicine yesterday published an article by economist and senior fellow at international health foundation Project HOPE Gail Wilensky, who writes her prescription for successful reform of the industry. Basically, she calls for starting from scratch, which won’t happen. But she proposes an evidence-based strategy for medical liability reform to be a significant part of a new bill.
Wilensky says malpractice reform is “an issue of great importance to physicians and hospitals and an important enabler of cost containment. I would propose that physicians and institutions that agree to adopt a set of patient-safety measures developed by the Institute of Medicine and that follow the clinical guidelines and protocols developed by the relevant medical societies or by a group of clinical representatives convened for that purpose should be granted immunity from liability unless there are provable charges of criminal negligence. This strategy of pairing liability reform with evidence-based medicine rather than relying on arbitrary caps on malpractice awards might appeal to Democrats as well as Republicans.” The full article is here and worth a read (although it may be too late).