Big Sky Cairn

Despite his cheerleaders on the lefty blogs, and in the newspapers, the fact Baucus failed to override the 10.6% cut in physician reimbursements is an astonishing display of inept leadership.

I will say a couple things about what Jay posted over at LitW; first, President Bush did not propose these cuts (more on that later). Next, I really do not see an issue that is going to break down on party and ideological lines more than health care in the next couple years - so lets give some credit to the fact that a wide majority of House Republicans supported the measure along with the House Democrats.

That last point makes it all the more astounding that Max Baucus, with all his power, could not sway one more vote. Worse still, you could have seen this train wreck coming since last December at least.

A bit of background on the Sustainable Growth Rate (SGR), which is the cause of these drastic cuts.

Back in 1997, President Clinton signed the Balanced Budget Act which contained a new payment schedule for physicians in Medicare. The basic principle of the SGR is to keep the growth of Medicare costs in line with the overall growth of the US economy. This idea works great when you have more individuals entering the workforce than entering Medicare age and keep a good (2-3%) growth in the overall economy. Of course in the past couple years, especially in 2007-08, we have seen baby boomers entering the system and an overall economic slowdown. The formula being what it is says that in order to keep Medicare costs roughly in proportion to what they were last year huge cuts are needed to balance everything out.

Cuts have been scheduled for each of the last 3 years and Congress has always voted to override them, most recently in December.

If I were a physician, I would be wondering why my reimbursement is still an issue.

Max, with leadership abilities in tow, tried and failed to pass a patch twice. After the second failure he said he was going to work with Senate Republicans and President Bush to reach a compromise. What an amazing idea, work with people to get something done, brilliant!

Being a decent idea and all the Senior Senator went back on his word and now wants to give the failed bill another go.

This really should not be surprising. Max’s record on health care is abysmal. He failed to get an S-CHIP reauthorization passed and waited until this year to get “ahead” of the curve and look into our health care system.

Max has all those former staffers working in the pharmaceutical and healthcare industry, does anyone have to ask why he’s not looking out for the little folks when it comes to these issues?
As for his power, he has none and he’s fooled the Montana media for 15 years.
Few major bills that become law have his name on them, but he’s good at jumping on when the heavy lifting has been completed by junior senators.