On Thursday, Senate conservatives blocked a bill that would have averted a 10.6 percent cut in Medicare payments to doctors. The bill, which would have canceled a reduction in Medicare fees and increased doctor pay by 1.1 percent, passed the House last week 355-59. But the Senate failed to invoke cloture on the bill by only one vote.
I'll have to get a little wonky to explain, so bear with me. Buried deep in the bureaucratic bowels of this government's budget process is a formula that triggers automatic cuts in Medicare payments to doctors if spending in other categories goes over certain limits. It's kinda like the legislated limit on the amount of national debt, in that no one has ever taken it seriously. These Medicare cuts in doctor payments have always been restored in what is usually one of the most boring pieces of action on Capitol Hill. After all, who would be stupid enough to actually cut payments to doctors?
Thirty-nine Republicans, that's who. Ignore Harry Reid if you click on the link. Due to fucked-up Senate rules, he had to vote against the measure in order to be able to bring it up later. Which means it might get fixed Doc, but it might not. There is a real chance that you could be looking at a 10% cut in your Medicare pay. And the pay you get from every other insurance company that bases their reimbursement rate on Medicare.
Ha ha.
I gotta admit part of me loves watching the karma-go-around smack you right in the face. It's kinda funny to think how you enlisted Ronald Reagan to carry the water of the American Medical Association back in the day, secure in the knowledge you were the elite of society and therefore exempt from having to worry about things like how we could be a decent civilization. Now Reagan's political spawn are coming after you.
I repeat. Ha ha.
In California, they're coming after me as well, because this state thought it would be a hoot to put an actor in charge of things. See a pattern?
So welcome to the Republican shaft-up-the-ass club doctors and California pharmacists. Perhaps, if you win this legislative battle, you might be convinced to give a crap in the future about what is fair for people other than yourself?
Because you've seen what happens when you let them get away with fucking those at the bottom. It's only a matter of time before they decide they want higher-class bitches.
Wake..........up.
17 comments:
PS- Did you see the part where the measure failed by one vote? You know who had a vote, but didn't show up?
Ted Kennedy. But he has brain cancer. You know who else single-handedly had the power to pass this bill but couldn't be bothered?
John McCain, But he's busy, running for president and all.
Except that Barack Obama is running for president too, and he managed to find the time to vote.
Meaning that the 39 Republicans who gave the shaft to your family doctor have at least slightly bigger testicles than the man they nominated to lead them.
isn't ted k. around to vote?
i know he has brain cancer but i thought he had actually done some senate work since surgery...
p.s. please don't get peed-off.. but i have a pharm question.
how is it possible that a 93 yr okd 80# slightly confused lady gets 300# 4mg. generic dilaudid every thirty days?
she was brought into the er and had ooddles of bottles.. some newly filled, others from 3 years ago.
i think she brought in over 1,000 tablets.
subsequently i was informed by the younger/hip techs that dilaudid sells for $30 each.
Bernadette,
A quick scan of the record looks like Kennedy hasn't voted since May 15th.
McCain since April 8th. Meaning he's taken almost 3 months off from his job in order to seek a promotion....
Bernadette again,
All I have to say is.....wow. And that I think anyone who pays $30 for 1 Dilaudid tablet needs to find a new drug habit.
that is so totally wrong.. but i guess it's a mute point.
the promotion mcsame seeks is the beginning of the end!!
you guys in KALIFORNIA are really getting the shaft. I just recently learned that in my state, the medicaid recipients don't have to pay their copay simply by saying they don't have the money to pay the one dollar co-pay. They are supposed to come back in later and pay it... I'm sure you know how often that happens and like we are really able to keep track of it doing 600-700 Rx's a day.
Anyway, I've heard some folks really take advantage of the system
Bernadette, your techs are getting ripped off. My Suboxone pts tell me the price for hydromorphone around here is closer to $1.00- $1.25 per milligram.
At least you know she wasn't selling them... or they wouldn't have brought in oodles of tablets. I've seen patients' "clients" follow them in to the ER to make sure their supply isn't interrupted.
right! she wasn't selling them; nor did she have any hipster lurking around for the scam.
i guess 5 bucks each is more reasonable.
Just so you know, its not just the docs getting screwed here. It's the pharmacists, too. Other provisions in the bill include one that provides incentives for electronic prescribing, a "prompt payment" clause so that independent pharmacies can stop floating loans to pay the bills while the PBMs take forever to cut a check,and adding benzos and barbits to the Part D formulary (in 2013--I know, big deal). Most importantly, it would delay the implementation of an AMP-based reimbursement formula for Medicaid prescriptions. Pharmacists need this bill to pass just as much as physicians. For once the AMA and APhA agree on something...
Hydromorphone (Dilaudid), and Suboxone seem to be hits after the whole mess with Oxycontin. Especially since most (or all since most are the same) Rx insurances prefer unavailable generics to brand.
Any opinions on the mail-order biz? I prefer messing with one asswipe [aka Rx insurance] than multiples in the Corpo-Pharmacy. Still hoping for universal health care(in my lifetime that is).
Last time I looked moron you needed 60 votes to get cloture. Your great democrats had to vote it down also since they have THE MAJORITY.
Anonymous #3 has presented us with a textbook example of how a little knowledge can sometimes be worse than none at all. Undoubtedly thinking himself quite the political insider for being able to throw around terms like "cloture" and being able to associate it with 60 votes, he feels confident to call others morons.
But tell me anonymous #3, do you know what cloture is? Don't answer. It's obvious from your statement you don't, and I won't humiliate you further by making you admit it. You caught me in a good mood. Other days I would take great delight in humiliating you.
For those of you who don't go around shooting off your mouth when you don't know what the hell you're saying, I'll clue you in. "Cloture" is a fancy term for "stopping debate." In the Senate, you're allowed to talk as long as you want while a bill is being debated, and while it used to be an extremely rare maneuver for Senators to threaten to talk forever to stop a bill from being passed, Republicans have made it routine in recent years, doing so on almost every bill. The only way to shut them up is to "invoke cloture", which takes 60 votes.
Anonymous #3 seems not to be aware though, that there are 49 Democrats in the Senate. Throw in 2 independents and using a complex mathematical formula beyond the capabilities of anonymous #3, we get 51. Which is less than 60.
Which means the 49 Republicans can stop any bill they want by refusing to vote for cloture. Again, I'll illustrate this mathematically:
100 Senators - 49 Republicans = 51 Senators. Not enough to invoke cloture.
I won't humiliate you anymore than you just humiliated yourself anonymous #3. I will just hope you've learned something about the importance of knowing what big words mean before you start throwing them around.
Moron.
Update.....due to some missed moderation of comments....the moron is now anonymous #4....
Clinton and Obama voted yey.
Mcain: No vote
shouldnt this be in the "news"?
By the way, I'm not the stupid anonymous 3 or 4 or whatever but I appreciate the civic lesson. Our pharmacy unfriendly president has vowed to veto this bill even if it passes this week. In order to budget more money to docs they are taking money away from his friends in the Medicare Advantage business. So regardless of who shows up we are screwed unless they take the money from someone else or get ten more pharmacy unfriendly republicans in the senate to defect and get a veto proof majority. We'll see...
OregonIndependent
Oh Drugmonkey,
Just your luck when you open your mouth those silly Republicans did do the right thing and pass this bill yesterday and with a veto proof majority. I am surprised too...how often does anyone in Washington do the right thing?
OregonIdependent
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