The American College of Physicians (ACP) took aim today at the country’s “broken politics,” telling Congress that it should replace $1.2 trillion in across-the-board budget cuts beginning in 2013 with a new budget package that preserves essential health programs while achieving similar or greater savings.
“As we enter a 2012 election that may determine the direction of health care for decades to come, ACP calls on the candidates to rise above the fray and provide clear answers on how they would improve American health care, not use vague rhetoric about the value of the status quo or the past,” said ACP President Virginia Hood, MBBS, MPH, during a teleconference.
In a new report, the ACP noted that failure last year of the so-called Super Committee to agree on deficit reduction measures triggers a 10% cut in defense spending; a 7.8% reduction in domestic spending; and a 2% cut in Medicare payments to physicians, hospitals, graduate medical education programs, and other health professionals. For physicians, reimbursement reductions are on top of pay cuts imposed by Medicare’s Sustainable Growth Rate (SGR) formula.
The upcoming budget cuts will affect state and local public health departments, where 49 000 jobs have been lost since 2008, as well as Medicaid programs; Health Resources and Services Administration programs that aid uninsured and medically vulnerable people; and the National Health Service Corps, which provides scholarships and medical school student loan forgiveness for clinicians who work in underserved areas.
To preserve key health programs, the ACP recommended the following action in 5 policy areas:
• Use funds being diverted from the wars in Iraq and Afghanistan to repeal the SGR and create new reimbursement models that reward quality rather than quantity.
• Reduce the costs of defensive medicine with medical liability reforms, including caps on noneconomic damages and no-fault health courts.
• Spend Medicare dollars more wisely by allowing the federal government to negotiate drug prices or require a rebate from drug manufacturers under Medicare Part D, creating a single deductible for Medicare Parts A and B, pricing services more accurately, requiring all payers to contribute to graduate medical education, and allowing Medicare to consider the comparative effectiveness of different treatments in coverage decisions.
• Reform federal tax policies to limit amounts of health insurance that are tax deductible.
• Establish an initiative with multiple stakeholders—physician groups, health plans, federal agencies, consumers, and health services researchers—to reduce ineffective care and promote high-quality care. An estimated $700 billion is spent annually on ineffective care.
Bob Doherty, the ACP’s senior vice president of governmental affairs and public policy, noted that many of the ACP’s ideas for cutting health care costs have received support from other medical groups as well as the Simpson Bowles Commission, a bipartisan group created by President Obama to address the federal deficit.
“Regrettably, a broken political culture that demands confrontation over compromise has made it impossible for Congress to achieve agreement on such common-sense, common-ground approaches,” said Doherty. “Too often, intriguing ideas from all sides are subjected to misleading attacks in order to score political gains.”