The Senate's vote to advance the health care reform bill Sunday couldn't have been more dramatic. With the Capitol still blanketed under two feet of heavy snow, lawmakers spent the entire day engaged in intense debate, with the final vote coming at 1 a.m. It became necessary to wheel 92-year-old Sen. Robert Byrd (D-W. Va.) into the snow-muffled Capitol to prevent any deadlocks based on procedural motions.
In that vote, all 58 Senate Democrats were joined by independent Sens. Joseph Lieberman (I-Ct.) and Bernard Sanders (I-Vt.) to defeat a Republican filibuster.
The final vote was 60-40, with all 40 Republicans opposed to moving forward with the Senate bill.
Impact on docs: Physician groups, including the AMA, expressed support for the bill following a last-minute "manager's amendment" tacked on by Senate Majority Leader Harry Reid (D-Nev.).
"We are pleased that the manager's amendment addresses several issues of concern to AMA," said AMA President-elect Cecil Wilson, M.D. "It increases payments to primary care physicians and general surgeons in underserved areas while no longer cutting payments to other physicians. It eliminates the tax on physician services for cosmetic surgery and drops the proposed physician enrollment fee for Medicare."
What happens next: Now that both the House and Senate have passed their versions of health reform, the two versions must be merged into a single, final bill. Remember: The House bill is a different animal and includes a government-run health insurance option as well as provisions for creating two Medicare Physician Fee Schedules (PBN 6/15/09).
Your top issue, a permanent fix to the sustainable growth rate (SGR) formula , is looking more and more like something that will be addressed outside of health reform, in a separate bill.
Even the AMA's Wilson described it as such: "Separate action is needed early next year to permanently repeal the current Medicare physician payment formula to provide a stable payment system to preserve access to care for America's seniors, baby boomers and military families."