State Society President: Mcare Will Be Priority This Fall
Dear Medical Society Member:
Mcare abatement for this year and Mcare phase-out remained unresolved as legislators went home for their summer recess on July 4. We are determined to ensure that they will face the urgent issues of health care for the uninsured and the Mcare crisis—linked by Gov. Ed Rendell—when they return in the fall.
In the meantime, however, many of us are now enduring the worst possible situation for recruiting young physicians into our practices because of the Mcare crisis combined with low reimbursement rates from both private and public insurers.
As a Pennsylvania physician who has received the Mcare abatement in past years, I too, am frustrated with these circumstances. I am saddened for our patients. Daily, I hear physicians’ dire concerns for the welfare of Pennsylvania medicine. As a physician and a Pennsylvanian, I share your immense concern about patient care and access.
Yet my message to all Pennsylvania physicians at this critical juncture is a positive one: There has been progress. And yes, we have work to do in the fall. But we must continue to work together to protect health care for Pennsylvanians.
Progress made
We have been successful so far in:
- Convincing policy makers on both sides of the aisle of the turmoil that linking Mcare and health care reform can cause to Pennsylvania’s health care access
- Generating strong, bi-partisan interest among legislators in a state-sponsored phase-out of the Mcare Fund
- Getting the message across that Mcare phase-out and Mcare abatement are equally critical to protect physicians from unaffordable increases as our primary coverage layer grows to 100 percent in a phase-out plan.
- Making it clear that the Society supports expanded coverage for the uninsured and keeps an open mind about health care reform.
- Making it clear that reforms expanding coverage for patients while restricting the viability of physicians’ practices cannot result in meaningful system reforms.
Strategy remains sound
Some have criticized the Medical Society for not supporting Senate Bill 1137—a plan advanced by the Rendell Administration and House Democrats that linked expanded coverage for the uninsured through PA ABC to Mcare abatement and phase-out—when it was considered by the House several months ago.
We expressed several serious concerns about SB 1137, as passed by the House. It would require physicians who receive abatement to participate in PA ABC and CHIP (Children’s Health Insurance Program), preventing them from negotiating a reasonable reimbursement rate from health insurers because they would simply have no bargaining leverage. It would have literally left Pennsylvania physicians with a $100 million bill to pay when the Mcare phase-out was completed. And finally, it contained numerous problematic technical issues.
As expected, the Senate’s response to the House version of SB 1137 was not positive. The Senate, in turn, linked Mcare to the re-authorization of the Pennsylvania Health Care Cost Containment Council (PHC4). While PHC4’s temporary shutdown was reversed by executive order of the governor, this fall the legislature must still resolve PHC4 reauthorization, along with Mcare abatement and phase-out and health coverage for the uninsured.
As you would expect, physicians and patients now remain trapped in the political middle.
The truth is we’ve convinced the legislature on Mcare. Our goals are still very attainable. While House Democratic leaders successfully blocked our efforts to re-insert a “pure” Mcare abatement extension amendment—without linking it to Pa ABC or to PHC4—there has never been a losing substantive vote on extending the Mcare abatement program. The funds remain intact in the state budget to provide for Mcare abatement when the political impasse is resolved. Mcare abatements can be retroactively applied for those physicians who choose to make that request.
Next round
I realize that many physicians are analyzing their professional and personal plans for the future, which is of course the responsible action. I would urge that, as you do so, you also consider your own commitment to advocate for your patients. Please consider not only the shifting political factors surrounding Mcare, but also the need for renewed physician action to preserve access to care in the commonwealth.
Over the summer months, we will continue to aggressively press home with key policy makers the vital importance of continuing Mcare abatement and a responsible Mcare phase-out plan.
The Society will ensure that physicians’ voices are clearly heard in the debate on the various elements of health care reform. Just today, I am gratified to learn that Senator Specter voted yes on reversing the Medicare payment cuts—as we had urged him in a face-to-face meeting in his Washington, D.C., office just two days before the vote. You can count on us to make sure your message reaches our elected officials.
This fall, we count on you—our members—to be ready to answer our call to action. Physicians have no greater weapon for patient advocacy than our collective voices.
Watch for updates at www.pamedsoc.org, and continue to tell us your stories as you, your patients, and your practice are impacted by Mcare, Medicare, and other key issues.
Thank you for your continued support of the Pennsylvania Medical Society and our efforts to improve the quality of health care for our patients.
Peter Lund, MD, FACS
President
Last Updated: 7/10/2008