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Does the Max Baucus health reform plan do enough for doctors?

Glenn Laffel, MD, PhD
Policy
October 10, 2009
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Max Baucus’ decision to release his solo album—subtitled the Senate Finance Committee’s proposal on health reform—was timed with the precision of a 4th grade marching band.

Physicians could live with that, but the bill contained gornisht on tort reform and not much more than that on Medicare reimbursement. Upon seeing that, the Long White Coats reacted as if they’d seen earwax on their stethoscopes.

“The feeling of most doctors is that what’s being proposed is not adequate,” Peter Levine, president of the Medical Society of the District of Columbia understated to the Washington Post.

Some docs even grumbled that the Montana Democrat swept aside tort reform after receiving a pep talk from Senate Majority Leader Harry Reid, a lawyer that has secured a million dollars plus in campaign contributions from lawyers and law firms already this year.

Of course this was just insult added to the injury caused by Obama’s airy drift over the subject of tort reform during his speech before Congress 2 weeks ago.

The Long Whites have legitimate reasons to feel abandoned by the Big O, Baucus and the Dems. They had after all, voted for Obama in droves, and the AMA—which had reflexively opposed every single government effort to remake health care from Medicare to HillaryCare—came out bright and early in support of Obama’s reform plans, including the public option.

Obama reacted to the lounge chatter by announcing he would accelerate his program to sponsor state-level experimentation with tort reform, the one he first announced during the “You Lie!” speech.

The plan sets aside $25 million, to be allocated by HHS in the form of $3 million competitive grants, to help states and care systems test models that emphasize patient safety, reduce preventable injuries, foster improved communication between doctors and patients, ensure that patients are compensated in a fair and timely manner for medical injuries, and so on.

Grant allocation would be driven by the results of a “review of what works,” which is supposed to be completed by December.

And that’s it.

That is not going to cut it for the Long Whites, as BNet Health’s Ken Terry points out. Twenty-five mil is a ridiculously small amount of money for federal demonstration projects to begin with, and the underfunding problem will be complicated by competing objectives for the project: improving patient safety and developing new tort reform strategies.

Plus, the low top-end on grants, $3 million, means cash-strapped states will have to supplement the demos, which could sink the boats before they are christened.

Reaction from providers was swift and predictable. After describing the Big O’s plan as “smoke and mirrors,” Levine added this: “It’s all incredibly disingenuous…the president got up and gave a speech to the nation and said we need action now. But when it comes to medical liability reform and tort reform, it needs to be studied. The whole concept is so hypocritical.”

Maybe so, but credit Obama for understanding that the Feds can’t implement tort reform all by themselves, so long as states maintain jurisdiction in malpractice litigation and set insurance premiums.

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If we’re ever going to get the tort reform physicians so desperately want, Washington is going to have to work with the states, like it or not.

Glenn Laffel is Sr. VP, Clinical Affairs at Practice Fusion.

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Does the Max Baucus health reform plan do enough for doctors?
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