NEJM: Medicare Bill Big Win for AMA

The news section of the New England Journal of Medicine is usually a couple of weeks behind the news, but today's edition has a few comments worth noting.

First, former Health Affairs editor turned NEJM national correspondent John Iglehart in summing up the recently enacted Medicare bill calls the "showdown" a "significant victory for the American Medical Association and its allies." More importantly, he concludes the political alignments revealed during the battle over maintaining doctors' pay make long-term reform of the physician payment system unlikely:

No one is satisfied with the current formula by which Medicare calculates physician fees, but Congress has hesitated to act because of the hefty price tag that would be attached to any change deemed acceptable to both policymakers and physicians. Members of Congress have urged physician groups to develop their own proposals, but because any viable plan is certain to result in both winners and losers, organized medicine, too, has been reluctant to act. So for the time being, annual Band-Aids will continue to be the standard of care for Medicare's physician-payment woes.

Meanwhile, an article reviewing the prospects for a national Physician Payments Sunshine Act, which would require drug and other medical supplier companies to reveal all payments to doctors (it's going nowhere in the current session), contained this intriguing tidbit: "Discussions are ongoing about ending the commercial support of continuing medical education entirely." Now there's a story worth pursuing.