"Aguirre, Charlie
(Martinez)"
<charlie_aguirre@ To
martinez.senate.g "Rodriguez, Aileen (Martinez)"
ov> <Aileen_Rodriguez@martinez.senate.g
ov>
07/09/2008 05:09 cc
PM
Subject
Senator Mel Martinez: Physician
Reimbursement rates within Medicare
Article










Dear friends,

Attached is an article that US Senator Mel Martinez would like to bring to
your attention in regards to physician reimbursement rates within Medicare.
Please feel free to forward this article out to your colleagues.

Thank you and please contact myself or Aileen Rodriguez, Gulf Coast
Regional Director, here in the Tampa Office of Senator Martinez if you need
further assistance.


Charlie Aguirre

Special Assistant
Office of U.S. Senator Mel Martinez
--------



Senator Coburn, one of two physicians in the Senate, has an op-ed on thedoc-fix today which Senator Martinez wanted to bring to your attention. Itis attached below and available at:http://www.realclearpolitics.com/art...g_doctors.htmlReal Clear PoliticsSenate Leaders Holding Doctors HostageBy Tom CoburnAs a practicing physician currently serving in the United States Senate, Ihave been disappointed not only by Congress' inability to prevent cuts tothe physician reimbursement rates within Medicare, but in our colleagues'inability to debate the real issues at hand honestly and constructively.While I appreciate the desire of Senate leaders to speak on behalf ofdoctors, I believe, as a doctor, that the American people deserve a betterunderstanding of what is at stake in this debate, and in the larger debateabout health care.In short, the Senate's recent debate about physician reimbursement rateshas been nothing more than a regularly-scheduled hostage crisis in whichdoctors facing payment cuts are held captive by politicians who want toachieve unrelated ideological goals. In this case, the ransom Senateleaders are demanding in exchange for a doctor fix are cuts in thesuccessful Medicare Advantage program that gives seniors greater choice andaccess to health care.The real debate, then, is not about reimbursement rates, but government-runhealth care vs. individually-controlled consumer driven health care. Ifthat is the debate Senate leaders wish to have, they should have thatdebate directly - not stage a diversionary hostage-crisis that harmsdoctors and patients.As a doctor, the hostility toward private plans among some of mylegislative colleagues is confounding because private plans have a provenrecord of better benefits and quality, superior clinical expertise forcoverage decisions, and increased access for vulnerable and minoritypopulations. Medicare Advantage offers seniors personal choice and controlover their health care decisions. More than one out of every five seniorsrely on their Medicare Advantage plans to provide an alternative togovernment-run Medicare. Yet, the Democrats' plan would inexplicably limitthe availability of these options for seniors. This misguided position isnot based on any empirical data, but pure ideology and hostility toindividual freedom and choice in health care.The irony of this debate is that the so-called "crisis" in sustainableMedicare reimbursement rates is caused by policies that lead tounsustainable increases in costs. Medicare was designed so physicianreimbursement rates would keep pace with costs. Yet, this broken paymentsystem predictably leaves doctors facing a larger cut every successive year- hence the annual crisis that requires difficult maintenance. Instead offixing this problem once and for all, Senate leaders, and presumptiveDemocratic presidential nominee Barack Obama, want to not only enshrinethis dysfunctional model in Medicare but apply it to the entire health caresystem.As a doctor, I know first-hand that the result of such a scheme would benot merely an annual crisis, but a permanent crisis in which even more ofmy medical colleagues would leave the profession rather than contend withever-shrinking reimbursement rates and intractable bureaucrats inWashington. Senate leaders seem oblivious to the fact that this is animmediate - not far off - problem. Physicians across the country areincreasingly refusing to treat Medicare (and Medicaid) patients becauseWashington's manipulation of the health care market is failing. ExpandingWashington's lordship over health care would only reduce the number ofdoctors in the system as the number of seniors seeking to access Medicareswells.Regardless of the outcome of the doc fix bill, this debate is a reminder ofwhy physicians must get engaged in health care reform. Once we pass this18-month patch, we will have to come back and figure out how to prevent a21 percent cut in 2010. Doctors should make no mistake that the underlyingproblem is that bureaucrats and politicians in Washington are telling themhow much they can charge to see their patients. If our health care systemturns single-payer - as it eventually would under an Obama Administration -we won't be fighting cuts to care for our over 65 patients, but cuts overreimbursements for all of our patients.After a compromise is passed and the phony theatrics end, Congress shouldimmediately begin working on comprehensive reform. We can solve today'shealth care crisis by turning to a single-payer system - where care will berationed and physicians will have to fight for perpetual reimbursement ratefixes for all of the patients they see - or we can solve that crisis withsolutions that rely on American ingenuity and individual choice. Myexperience as a physician and legislator has taught me that the latter isthe only long-term solution that will work.In any event, our goal must be results for seniors and patients - notelection-year posturing. Physicians want to care for their patients andreceive a fair wage. Beneficiaries want the security of knowing medicalcare will always be available to them. We can achieve both if Senators areinterested in a solution, not just an election-year issue.

__________________


K12S / RRSS / 997S

My response to the above email:

As a VERY active Republican, a member of the RNC, RNP, TBYR, YR of Florida, and a practicing physician/surgeon in Florida, I find it hypocritical that Mr. Martinez would like this shared with various physician groups AFTER he voted against the HR 6331 resolution the FIRST time it was presented.

It took multiple phone calls by many of my colleagues and myself to Mr. Martinez's office to stress to him the importance of changing his position on this issue; I am pleased that he did, but what concerns me and my colleagues is the fundamental lack of understanding of what economic pressures we as physicians face on a daily basis. However, as a Republican it is SHAMEFUL to realize that Bill Nelson got it right the first time around. It is in fact downright EMBARASSING. Its even worse the Senator Kennedy was wheeled in to help lead the crusade against Republican mis-judgment in the second vote, after contending with a horrifying illness. It really makes us look bad as Republicans to the rest of the nation.

Several questions come to mind for the Senator:

Why is it that in every other industry, prices and wages go up (including minimum wage for the most unsophisticated jobs/workers), and in our profession, where we are held hostage to a 'higher standard' of morality, our reimbursement and ultimately wages go DOWN, as the costs of delivering healthcare continue to rise?

Why is it that our Republican Senators decided to put the our financial viability at stake to defend an questionable program of privatized Medicare for rural areas?

Why is Mr. Martinez NOW so concerned after he voted against HR 6331 the FIRST time around?

I would like to be educated on Mr. Martinez's 'change of heart' in this matter.

Quite frankly, I am concerned that Mr. Martinez does not truly represent our interests as physicians in the great State of Florida, where the ability to practice medicine is already hampered by the worst reimbursement rates for physicians for both public and private medical insurance plans with (still) higher malpractice and insurance rates.

I want to know exactly where Mr. Martinez stands on the issues that affect my profession the most. I must be assured and convinced that his 'eyes' have been 'opened' in regards to this matter; however, I must point out that there exist a group of us who will be scrutinizing Mr. Martinez's voting record very carefully to determine whether or not we, our friends, our families, and our colleagues, will be supporting his reelection campaign in 2010.

Please forward this to the Senator's attention.

Sincerely,

H. Drexel Dobson-Lopez III MD FACS
Saint Petersburg, FL 33704
------------------------------
Dear Dr. Dobson,

Tomorrow, the Senate is expected to vote again on the Medicare Improvements for Patients and Providers Act of 2008
(H.R. 6331). This legislation would block the 10.6 percent cut in
Medicare payments that took effect on July 1 and would replace the 5.4
percent cut in 2009 with a 1.1 percent increase. 39 Senators voted
"no" at the end of June, blocking this legislation from passing the
Senate despite overwhelming support for it demonstrated by members of
the House of Representatives only days before. If any one of those 39
Senators had voted "yes", the legislation would have passed the
Senate. Please review the list of how all Senators voted on this bill
that is included at the end of this email.

These 39 Senatorshave another opportunity tomorrow to stand with doctors and patients
and support H.R. 6331. We need you to call your Senators immediately
to express your unhappiness with the Senate vote and to urge your
elected Senators to vote for the reform legislation that will be
considered tomorrow. Your phone call is absolutely essential in this
effort to preserve access to surgical care. We know and appreciate
that many of you have called your Senators and Representatives over the
past few weeks, but we need to ask you to keep calling and to keep the
pressure on.

As soon as possible, please call:

Senator Bill Nelson at (202) 224-5274
and Senator Mel Martinez at (202) 224-3041

When you call, ask the person who answers the phone to deliver the following message to your Senator:

For Senators who voted YES:
Message
---- I am a surgeon from FL and would like to thank the Senator for
supporting H.R. 6331 -- The Medicare Improvements for Patients and
Providers Act of 2008. I urge him/her to continue to support the bill
in all future votes.

For Senators who voted NO:
Message
---- I am a surgeon from FL and I am very upset that the Senator did
not support H.R. 6331 -- The Medicare Improvements for Patients and
Providers Act of 2008. I strongly urge him/her to support the bill
when presented with another opportunity to vote on this critical
legislation.

Please let us know that you have made the call by replying to this email (ahp@facs.org),
which will go directly to the American College of Surgeons Washington
Office. This information will help us with our lobbying efforts.

We must keep the pressure on by continuing to call!

Thank you for your time and your efforts.

With all best regards,

Thomas Russell, MD, FACS
Executive Director
American College of Surgeons

###

39 Senators voting no
Alexander (R-TN)
Allard (R-CO)
Barrasso (R-WY)
Bennett (R-UT)
Bond (R-MO)
Brownback (R-KS)
Bunning (R-KY)
Burr (R-NC)
Chambliss (R-GA)
Coburn (R-OK)
Cochran (R-MS)
Corker (R-TN)
Cornyn (R-TX)
Craig (R-ID)
Crapo (R-ID)
DeMint (R-SC)
Domenici (R-NM)
Ensign (R-NV)
Enzi (R-WY)
Graham (R-SC)
Grassley (R-IA)
Gregg (R-NH)
Hagel (R-NE)
Hatch (R-UT)
Hutchison (R-TX)
Inhofe (R-OK)
Isakson (R-GA)
Kyl (R-AZ)
Lugar (R-IN)
Martinez (R-FL)
McConnell (R-KY)
Sessions (R-AL)
Shelby (R-AL)
Specter (R-PA)
Sununu (R-NH)
Thune (R-SD)
Vitter (R-LA)
Warner (R-VA)
Wicker (R-MS)

59 Senators voting yes
Akaka (D-HI)
Baucus (D-MT)
Bayh (D-IN)
Biden (D-DE)
Bingaman (D-NM)
Boxer (D-CA)
Brown (D-OH)
Byrd (D-WV)
Cantwell (D-WA)
Cardin (D-MD)
Carper (D-DE)
Casey (D-PA)
Clinton (D-NY)
Coleman (R-MN)
Collins (R-ME)
Conrad (D-ND)
Dodd (D-CT)
Dole (R-NC)
Dorgan (D-ND)
Durbin (D-IL)
Feingold (D-WI)
Feinstein (D-CA)
Harkin (D-IA)
Inouye (D-HI)
Johnson (D-SD)
Kerry (D-MA)
Klobuchar (D-MN)
Kohl (D-WI)
Landrieu (D-LA)
Lautenberg (D-NJ)
Leahy (D-VT)
Levin (D-MI)
Lieberman (I-CT)
Lincoln (D-AR)
McCaskill (D-MO)
Menendez (D-NJ)
Mikulski (D-MD)
Murkowski (R-AK)
Murray (D-WA)
Nelson (D-FL)
Nelson (D-NE)
Obama (D-IL)
Pryor (D-AR)
Reed (D-RI)
Reid (D-NV) (switched his vote to No in order to bring the bill back for another vote)
Roberts (R-KS)
Rockefeller (D-WV)
Salazar (D-CO)
Sanders (I-VT)
Schumer (D-NY)
Smith (R-OR)
Snowe (R-ME)
Stabenow (D-MI)
Stevens (R-AK)
Tester (D-MT)
Voinovich (R-OH)
Webb (D-VA)
Whitehouse (D-RI)
Wyden (D-OR)

2 Senators not voting
Kennedy (D-MA)
McCain (R-AZ)
----------------------------------

Why are those the only 2 choices?

How about a single-payer system that receives a proper budget, where care is not rationed and physicians are paid fairly?

Maybe our politicians need to fund health care with the priority that they fund national defense.



They do not care about doctors, but care more about the financial well-being of the large drug companies and medical facilities. How much money did the politicians receive in campaign donations from doctors, and how much did they receive from big pharma, the insurance companies, and the large hospital corporations?

I'd be pissed if I was a doctor as well. Unfortunately, this is the nature of our current political system. Politicians make their policy decisions based on what will give them more campaign contributions. Ideology or doing what is right rarely plays a role in their decisions.

__________________


my experience on X5world when I spend too much
time posting in political threads in the lounge...

Are you offering health benefits to your employees yet? Perhaps Upgraded to a premium membership??

I wish they didn't cut the 10% out of Medicare Advantage, it's only going to create less benefits with a higher price for our fixed income senior citizens. At the same time I don't agree with cutting 10% from doctors. I would say we should get creative, but our government doesn't know how to do so, When did they start hating Capitalism? I don't get it

__________________
RIP Equality, It was nice to meet you this summer...

The purpose of health care should be to treat people, not to make money. The moment that making money became more important than providing good health care, that is when "they" started hating capitalism.

Time for a strike...

__________________

Our economy is very impacted by our inefficient health care system. Old people and those with long-term problems are completely taken out of the economy. Our manufacturers have to pay for health insurance and our competition doesn't. That is one reason our economy is being sent to other countries.

It is obvious that our "pro-business" neocon types are doing more to screw up our capitalist system than any "liberals" ever could. Oh, I forget, our Beloved Leader says we should have savings for medical costs. Damn, I plum forgot to save up that half-mil or so.

Or are we all just the whiners and complainers Sen. Graham said we were?

Interestingly, all my many kind and competent doctors ranted about the need for a single-payer system. Guess they don't worry about the dreaded "socialized medicine" boogyman anymore.

Congress, Overriding Bush, Blocks Pay Cut for Doctors

Looks like the Democrats are taking the side of the doctors here.

Wrong:

The purpose of health care is to treat people and make money.

IMHO there's Nothing wrong with doing both.

But you will always have people who believe that making money is more important than anything weather it's a Garbage man or a Doctor.

__________________
People pay for what they do, and still more for what they have allowed themselves to become. And they pay for it very simply; by the lives they lead.
James A. Baldwin