The legislators took turns complimenting each other for a new spirit of cooperation. They'd used heated rhetoric to bash each other Thursday night after a $118-billion package for a six-month delay in the Medicare pay cuts plus a finance package that extended jobless benefits and provided $24 billion to states for their Medicaid programs failed to pass.

The new pact was brokered by Senate Finance Committee Chair Max Baucus (D-MT), who said the agreement was a "good omen" that the two parties could work together on the rest of the finance package in the future.

The last-minute agreement means that the pay cuts, which technically went into effect June 1, will be rescinded, and physicians will be paid the full amount of their Medicare fees. If the Senate hadn't acted, the cuts would have gone into effect today.

Medicare contractors were ready to start processing June claims at the reduced rate. But the Center for Medicare and Medicaid Services (CMS) was holding up the claims, anticipating that Congress would stop the reduction retroactively.

The House of Representatives must still pass the measure, and that's likely to happen Monday. The CMS acknowledges that the uncertainty about the fee cuts and delayed processing of Medicare claims may present cash-flow problems for some doctors. It expects the delays to be only a few days.

Medical groups are still upset that the "doc fix" is only for six months instead of a longer reprieve from threatened pay cuts.

"The reduction in payments, even if temporary, creates havoc for practices," the American College of Physicians said in a statement. "The situation is unacceptable, and the frustration and anger is understandable." It said doctors need stable and predictable payments and called for a permanent fix.

Even before the vote Thursday, the American Medical Association at its annual meeting in Chicago mocked Congress for failing to grapple with the pay issue, saying the "Senate fiddles as Medicare burns" and that a six-month reprieve was inadequate.

The Medicare pay-cut issue is the result of a decade-old formula, called the sustainable growth rate, set up by Congress to slow the growth in Medicare spending. Reimbursement rates for Medicare would have been trimmed on a yearly basis. But Congress has deferred the cuts nine times since 2003, almost always just days before planned cuts would take effect. Changing the formula wasn't included in the healthcare overhaul President Barack Obama signed into law in March.

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Opinion: The 2010 Medicare Fee Schedule: Almost 1700 Pages Outlining How We Get Ripped Off by the Government That No Average Citizen Can Comprehend (Don't worry, we doctors and most economists don't really understand it, either).  We'd show it to you, but since the fees are based on the AMA's CPT codes for billing, the information is proprietary and copyright protected.  If you didn't want socialized medicine, you should have told some folks in the '60s.  We actually agree with Barry Goldwater on this one.  We're nearing terminal velocity on this black diamond slippery slope. 

Brace yourselves.  Yes, indeed, we already have socialized medicine in America-just an incredibly arcane and disorganized form of quasi-capitolistic, inefficient, and over-priced socialized medicine.  European Medicine is like shopping at Wal Mart: All the stores look alike, and you'll get decent, but not necessarily exceptional-quality goods and services.  American Medicine: Too crazy to draw any valid comparison.  American Government: crazier and more corrupt.  Our average citizen: no hope there, either.  We spend just 0.3% more on healthcare than we do for entertaining ourselves on a yearly basis.  Yes, we sure do have our priorities in order. 

Since the government sets the standard and most insurers are in lockstep with CMS (the agency that controls government healthcare programs), is there any reason we're making a big deal about this re-packaged deal nicknamed "ObamaCare?"  The real question becomes: Is this ultimately good for patient care in the long run?  We say no.  Entitlements should be a helping hand, not a way of life.  We believe in health care opportunities for all Americans; but if health care is a right (like, apparently, gun ownership is), then why not food, clothing, shelter and bullets?  For a country that seems to hate corporate bailouts, we certainly don't complain about our personal handouts from Uncle Sam. We submit that it is time to embrace the stark reality of our situation and encourage real innovation in healthcare culture, reimbursement reform, and research.  Let's work on cures for diseases, not better bandaids and the 7th generation of the little purple pill.   

http://www.visualeconomics.com/how-the-average-us-consumer-spends-their-paycheck/

http://www.visualeconomics.com

After two days of deliberation, a Food and Drug Administration (FDA) advisory panel voted Wednesday to keep the diabetes drug Avandia on the market despite studies that suggest the medication puts people at greater risk of heart attacks and strokes. The decision was hardly decisive. Among five possible recommendations, the option to withdraw Avandia from the market received the most votes, however a majority voted to keep it on the market in some form. Thus the drug will still be available.  (end citation)