Congress faces one-month deadline on doctor payment fix

The doctor payment fix and several marketplace issues, such as insurance red tape and malpractice cases, continue to loom while health care reform efforts stall.

The Hill: "At the end of February, a short-term measure enacted late last year will expire, exposing doctors who treat Medicare patients to a 21 percent reduction in their fees. The American Medical Association (AMA) and other physician groups are continuing to lobby lawmakers to enact a costly permanent reform to the complex formula that calculates the payment levels." But the Senate's plan for pay-as-you-go budgeting might ease the problem. That legislation requires lawmakers to "offset all new spending or tax cuts with cuts to existing spending or tax increases. The House passed a similar bill last year and is slated to take up another version next week. ... The bill, however, includes exemptions for several costly items, including the doc fix. Specifically, the legislation would allow Congress to spend up to $82 billion more on physician payments without offsetting the spending" (Young, 2/1).

The Minneapolis Star Tribune reports on doctors' frustration with health insurance red tape. The Tribune focuses on the experience of Dr. James Eelkema, a family doctor who "quit a large family medicine clinic last summer and set up his own shop, TimeWise Medical, in Burnsville." Eelkema completely gave up insurance paperwork and "is one doctor swimming against the tide. The number of solo family practitioners has fallen precipitously in the past two decades as medical care has grown more complex -- along with the billing. But he's also a potent symbol of the times: Doctors spend more of their day complying with insurance rules, which are usually well-meaning but take time away from patient care" (Yee, 1/31).

The Des Moines Register: "Iowa patients are suing their doctors for malpractice half as often as they used to, which has helped drive down malpractice-insurance premiums for many physicians. Doctors speculate that malpractice lawsuits are becoming rarer because they have cut down on medical mistakes." But some plaintiffs' lawyers say the reason behind this trend is that pressing lawsuits has become more expensive. "Despite the decline in cases, the two sides continue to debate whether malpractice lawsuits help drive up health care costs" (Leys, 1/31).

The New York Times reports on efforts to control improper drug promotion: "The Food and Drug Administration has cracked down on one of the most widely quoted cosmetic doctors, sending shudders through the ranks of opinion leaders in fashion publishing and vanity medicine. The F.D.A. recently sent a warning letter to Dr. Leslie Baumann, a well-known dermatologist and clinical researcher in Miami Beach, citing the doctor for expressing premature enthusiasm in the media about Dysport, an injectable antiwrinkle drug the agency had not yet approved. Dr. Baumann's comments in the media in 2007 violated restrictions on drug promotion, according to the letter. ... This is believed to be the first time the agency has warned an individual investigator — a medical researcher who oversees a clinical trial — for apparently promoting an unapproved drug" (Singer, 1/31).