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Published 8/1/2014

Reader Holds Congress Accountable

It was extremely disappointing to see efforts to repeal the Sustainable Growth Rate (SGR) provision fail once again. As reported in AAOS Now (May 2014), orthopaedic leadership devoted many resources to support and advise legislators in developing an unprecedented, bipartisan, and bicameral agreement on a permanent repeal of the SGR.

Hopes were high that we would finally fix this flawed system and its last-minute “short-term patches” that threaten medical practices and Medicare beneficiaries. These hopes were dashed when House Republicans, instead of constructively working on ways to fund this measure, decided to cast one more vote to undermine the Affordable Care Act (ACA). They should be held accountable for this cynical political act.

According to Thomas C. Barber, MD, chair of the AAOS Council on Advocacy, the House measure to couple the SGR fix with a 5-year delay in the ACA’s individual mandate was “another attack on ObamaCare, which is in and of itself not a problem, but it means that the legislation will be dead on arrival in the Senate.” This obsession to cast symbolic votes against the ACA is a problem, especially when it undermines crucial legislation that would protect Medicare patients’ access to their physicians.

The ACA is the law of the land and polls clearly show that, although the public may not support all its aspects, most do not want to see it repealed. It’s time for legislators and our Academy leadership to look for ways to constructively improve and implement this law.

How can the SGR fix be funded? Senators Angus King (I-Maine) and John D. Rockefeller (D-W.Va.) have introduced the Medicare Drug Savings Act, a bill that would offset the $140 billion SGR-fix price tag by allowing Medicare to negotiate prices for drugs that are prescribed to elderly Medicaid patients. This would seem to make a lot of sense but I assume it has gotten little attention because of the lobbying power of the drug companies and their ability to influence elections.

It’s time for legislators to put politics aside and do what is right for our patients and our medical practices.
Paul R. Cain, MD

Auburn, Maine

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