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More Health Care Screw Ups

May 26, 2010

The Medicare “doc fix” is back in play on Capitol Hill, and its mere mention provokes a torrent of scorn and vitriol rarely seen among the generally mild-mannered community of policy mavens who inhabit the nation’s think tanks and universities.

“It’s one of the worst pieces of legislation I’ve ever seen,” said Stuart Altman, a former adviser to Congress on Medicare who now teaches health policy at Brandeis University. “I don’t think I’ve ever felt so vindictive about a piece of legislation in my life.”

“It’s a charade,” said Henry J. Aaron, a health policy analyst at the Brookings Institution. “Congress takes care of things but doesn’t actually do anything. They haven’t been willing to write up the full cost of changing the system, so the projected deficits don’t look as bad as they are.”

In health policy circles, the “doc fix” has become emblematic of Washington’s worst habits: a potentially solvable policy problem run amok for about a decade now, bogged down in pure politics and accounting gimmicks.

The “doc fix,” a last-minute infusion of funds to head off a looming doctor pay cut under Medicare, hits the floor this week via the tax extenders bill and, if passed, will stabilize Medicare payments through 2013 at a cost of $63 billion over the next 10 years, according to a Congressional Budget Office estimate.

Without those funds, physician payments stand to drop 21 percent June 1.

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