# Dear Congress: stop holding my patients hostage to you stupid pissing contests **URL:** \ **Category:** The BBQ Pit\ **Created:** [June 24, 2010, 6:43am UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330 "2010-06-24T06:43:33Z")\ **Posts on this page:** 14\ **Page:** 3
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [June 25, 2010, 11:21pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/41 "2010-06-25T23:21:21Z")
> [@begbert2](#): > > **Smashy** , you need to get your assumptions checked. OK, enlighten us. As Grassley put it > [@](#): > > Despite current unfunded liabilities of more than $37 trillion over 75 years, cuts Medicare by half a trillion dollars, not to strengthen Medicare but instead to fund yet another unsustainable new health care entitlement program. > Relies on savings from permanent cuts to payment updates that the Administration’s own Chief Actuary has called “unrealistic” and “unlikely to be sustainable on a permanent annual basis.” These types of cuts, which can result in negative payment updates, would “possibly jeopardize access to care for beneficiaries” **as providers end their participation in Medicare**. > > (Bolding mine, seems important as this is the OP’s thoughts) and further > [@](#): > > [the healthcare bill] Ignores the biggest payment problem in Medicare, the physician SGR, and leaves it virtually unsolvable in future years by making further Medicare cuts unrealistic as an offset to pay for a permanent solution. The CMS Actuary noted that reforms to the SGR physician payment mechanism “would increase Medicare costs by an estimated $214 billion” during the 10 year budget window in the House bill. Those provisions have been put into a separate bill so they would not be included in the cost of health reform when reforming physician payment is one of the most critical issues facing Medicare today, and one that should be at the top of the list of Medicare reforms. This doc is dated 6/21 of this year so I assume it’s what was in the bill. ---
**Author:** ![Sinaptics](https://avatars.discourse-cdn.com/v4/letter/s/278dde/32.png) [@Sinaptics](https://boards.straightdope.com/u/Sinaptics)\ **Post date:** [June 26, 2010, 2:54pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/42 "2010-06-26T14:54:56Z")
So basically, we have a problem that Republicans and conservative Dems don’t want to pay to fix. So, we’ll just leave it alone and let it fester. I’m all for paying for the bill from other places, but not at the expense of losing doctors. Here’s a summary of the fight: [http://www.medscape.com/viewarticle/712775](http://www.medscape.com/viewarticle/712775) ---
**Author:** ![psychobunny](https://avatars.discourse-cdn.com/v4/letter/p/54ee81/32.png) [@psychobunny](https://boards.straightdope.com/u/psychobunny)\ **Post date:** [June 28, 2010, 5:52pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/43 "2010-06-28T17:52:45Z")
Just to update; the House caved and passed the Senate extension 417-1 (not sure who the one is) and the Pres signed it. So we have 6 months before we start this crap all over again except that by that time it will be a 26% cut unless they fix the SGR. What is frustrating is that everybody knows that you can’t cut Medicare reimbursement that much but nobody actually wants to fix the problem. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [June 30, 2010, 4:54pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/44 "2010-06-30T16:54:16Z")
> [@Sam\_Stone](#): > > Those who rely on government eventually discover that government is unreliable. The problem is the 41% of Congress whose agenda is deliberate sabotage: making Americans hate their government is their political “philosophy.” > [@Shodan](#): > > Actually it is the old “we can’t do anything because those fiendish Republicans have us out-numbered 41 to 59” excuse. Yes, it would be funny … if it weren’t so sad. When 49 Democrats try to prevent Republican perfidy, they’re defying the will of the prople. But 41 Republicans trying to stop progress are a tribute to our Founding Fathers’ wisdom. Beck and Limbaugh keep trying to outdo each others’ inanities for higher ratings; the rest of the media goes along for laughs; and America becomes a laughingstock. In the context of SDMB, what’s sad is that some Dopers pretend they don’t see this. ---
**Author:** ![smiling\_bandit](https://avatars.discourse-cdn.com/v4/letter/s/e9a140/32.png) [@smiling\_bandit](https://boards.straightdope.com/u/smiling_bandit)\ **Post date:** [June 30, 2010, 5:45pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/45 "2010-06-30T17:45:06Z")
> [@septimus](#): > > The problem is the 41% of Congress whose agenda is deliberate sabotage: making Americans hate their government is their political “philosophy.” You heard it here folks: this is what the Lefties are reduced to. The best they can do is claim that Republicans are trying to deliberately destroy the country by trying our darndest to save it from complete fiscal collapse. Yep, you got us. IN order to win the election we’re compelktely dedicated to ruining the entire American economy. We’re also the cause of all the world’s wars, which we started to satiate our greed and scratch our long noses. And we drink the blood of Democrat babies. ---
**Author:** ![jayjay](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jayjay/32/6765_2.png) [@jayjay](https://boards.straightdope.com/u/jayjay)\ **Post date:** [June 30, 2010, 6:19pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/46 "2010-06-30T18:19:35Z")
> [@smiling\_bandit](#): > > You heard it here folks: this is what the Lefties are reduced to. The best they can do is claim that Republicans are trying to deliberately destroy the country by trying our darndest to save it from complete fiscal collapse. Yep, you got us. IN order to win the election we’re compelktely dedicated to ruining the entire American economy. We’re also the cause of all the world’s wars, which we started to satiate our greed and scratch our long noses. And we drink the blood of Democrat babies. I don’t think the Republicans are _trying_ to destroy America. I think that Republican policies (which seem to be more about small-minded revenge for losing power than about responsibly governing the country) WILL destroy America. There’s a difference. ---
**Author:** ![smiling\_bandit](https://avatars.discourse-cdn.com/v4/letter/s/e9a140/32.png) [@smiling\_bandit](https://boards.straightdope.com/u/smiling_bandit)\ **Post date:** [June 30, 2010, 8:26pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/47 "2010-06-30T20:26:22Z")
> [@jayjay](#): > > I don’t think the Republicans are _trying_ to destroy America. I think that Republican policies (which seem to be more about small-minded revenge for losing power than about responsibly governing the country) WILL destroy America. There’s a difference. The only America we intend to “destroy” is the nightmare the Left intends to create. And in any case, I wasn’t talking to your comments. Now, if you’ll excuse me, I need to devour the sweet, tangy blood of poor orphan Democrat babies. ---
**Author:** ![Shot\_From\_Guns](https://avatars.discourse-cdn.com/v4/letter/s/ccd318/32.png) [@Shot\_From\_Guns](https://boards.straightdope.com/u/Shot_From_Guns)\ **Post date:** [June 30, 2010, 8:46pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/48 "2010-06-30T20:46:13Z")
Make sure they aren’t darkie babies. “One drop” and all that. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [June 30, 2010, 8:46pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/49 "2010-06-30T20:46:51Z")
> [@smiling\_bandit](#): > > The best they can do is claim that Republicans are trying to deliberately destroy the country … Yep, you got us. IN order to win the election we’re compelktely dedicated to ruining the entire American economy. I agree it is frightening and disgusting that the Republicans would do so. But many commentators much more competent that you, Mr. Bandit, suspect that is precisely what they do. As [just one example](http://yglesias.thinkprogress.org/2010/06/senate-republicans-team-up-with-ben-nelson-to-strangle-economic-recovery/): > [@](#): > > It’s unpleasant to think about, and I really hope it’s not true, but it may be time for a discussion about whether GOP lawmakers are trying to deliberately sabotage the economy to help their midterm election strategy. After all, these same Republicans have supported deficit-financed tax-extenders before — there’s no credible reason to change course now. On the contrary, with the economy struggling to break through, the need for this package is more obvious, not less, if your goal is to actually improve economic conditions. ---
**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\ **Post date:** [June 30, 2010, 9:10pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/50 "2010-06-30T21:10:21Z")
I cannot _wait_ to vote against Sen. Hair Helmet, I mean Nelson. ---
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [June 30, 2010, 10:13pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/51 "2010-06-30T22:13:32Z")
> [@smiling\_bandit](#): > > The only America we intend to “destroy” is the nightmare the Left intends to create. And in any case, I wasn’t talking to your comments. Yes, yes, that’s why some republican representatives when interviewed about the health care reform says it does a lot of good and necesary stuff but… not under Obama. Nope. Or when the US lost the prestige of hosting the olympics and you saw the video of all the right wing pundits jumping around and fist pumping, right? The current republican party would oppose a magical solution to all the world’s problems if it would make Obama look good in the process. ---
**Author:** ![The\_Tao\_s\_Revenge](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@The\_Tao\_s\_Revenge](https://boards.straightdope.com/u/The_Tao_s_Revenge)\ **Post date:** [July 1, 2010, 2:29pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/52 "2010-07-01T14:29:19Z")
> [@smiling\_bandit](#): > > The only America we intend to “destroy” is the nightmare the Left intends to create. And in any case, I wasn’t talking to your comments. What would that be? The one where folks on the right mindlessly support some idiot’s lies or hallucinations about Iraq and wastes trillions while letting trillions more in economic damage fester that he knew full well about but was too stupid, and at any rate economic regulation is bad so what could he do? Nope that’s all the right, you traitorous piece of garbage. Or do you mean the one where Americans have full healthcare coverage with costs much less draining on the economy? That would be the left, but people like yourselves who seem to want folks to die from treatable conditions or be needlessly crippled, and billions of dollars to be wasted, spew garbage like this. But go right ahead, keep listening to Rush, you lunatic. ---
**Author:** ![jayjay](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jayjay/32/6765_2.png) [@jayjay](https://boards.straightdope.com/u/jayjay)\ **Post date:** [July 1, 2010, 2:32pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/53 "2010-07-01T14:32:42Z")
> [@The\_Tao\_s\_Revenge](#): > > But go right ahead, keep listening to Rush, you lunatic. “Shows what you know! I don’t listen to Rush!” in 5…4…3…2…1… ---
**Author:** ![regginbrow](https://avatars.discourse-cdn.com/v4/letter/r/ba9def/32.png) [@regginbrow](https://boards.straightdope.com/u/regginbrow)\ **Post date:** [July 2, 2010, 6:54pm UTC](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330/54 "2010-07-02T18:54:48Z")
Back on topic, as someone on the commercial side, you can pretty much guarantee that these cuts will never go through, at least at the proposed 21.3-26% cut. Doing so would be political suicide, but instead of actually fixing the problems congress just passes these DocFixes whenever the cuts are about to come up. It must be a pain in the ass to deal with being jerked around and I definitely sympathize, but I would never expect for these cuts to implement in the long term. Hell, in the health insurance industry, we always operate under the assumption that a form of DocFix will be passed when projecting Medicare rates into the future, even when not on the political horizon. [Previous page](https://boards.straightdope.com/t/dear-congress-stop-holding-my-patients-hostage-to-you-stupid-pissing-contests/544330.md?page=2)