Surgeons oppose Senate healthcare bill

The American College of Surgeons and 19 other groups representing surgeons delivered a letter Wednesday stating their opposition to the Senate's healthcare reform legislation.

"We are writing today to reiterate our serious concerns with several provisions that were included in the health care reform bill that was considered by the Senate Finance Committee and to let you know that if these concerns are not adequately addressed when a health care reform package is brought to the Senate floor, we will have no other choice but to oppose the bill" (emphasis theirs), says the letter, signed by the American College of Surgeons and numerous societies of specialty surgeons and addressed to Senate Majority Leader Harry Reid (D-Nev.).

Though Reid has yet to unveil the version of the bill the Senate will debate, the surgical societies base their rejection on the measure approved by the Finance Committee last month.

The critical dispatch from American College of Surgeons contrasts sharply with its July endorsement of the House's original healthcare reform bill. The surgeons, like the American Medical Association (AMA) and other physician groups, backed the House measure in large part because it included a permanent reform the Medicare's broken payment system for doctors, which must be adjusted by Congress each year to prevent steep cuts.

The surgeons object to funds for surgeons being redirected to primary care physicians; a proposal to create an independent commission on Medicare payment policy that would not require congressional action to take effect; requirements that doctors participate in a quality measurement program; and other components of the Finance Committee bill.

Furthermore, the groups protest the Senate's decisions to not enact a permanent reform to the Medicare payment system and to not enact limits on lawsuits for medical malpractice.

The medical groups make clear they have stated their objections to senators in the past but have not had them rectified. "Since late last year and as recently as last month, the surgical community has on multiple occasions offered detailed comments on how the Senate’s policy options and legislative proposals can be amended," the letter says.

“There are ways to improve quality, cut costs and increase patient access — but the Senate isn’t hearing those of us who are closest to the patient and work in the system every day,” Brent Eastman, chairman of the College's board of regents and the chief medical officer at Scripps Health, said in a statement.

President Barack Obama and congressional Democrats have intensely sought the support of physicians for their healthcare reform efforts — so far, to little effect.

House Democrats initially secured a key endorsement of their healthcare reform bill from the AMA and a handful of other medical societies this summer. But when the House Democrats removed provisions to fix the Medicare payment system from their overall reform bill and introduced separate legislation, the AMA withheld its endorsement. Likewise, Reid failed in his gambit last month to move a $240 billion bill to reform physician pay because he could not win votes from Democrats who objected to increasing the budget deficit.

The AMA and the American College of Surgeons were among a coalition of physician lobbying groups who agreed to help Reid pass the so-called doctor-fix bill, reportedly in exchange for their support of healthcare reform.

In contrast to the surgeons' criticisms of the Senate legislation, the American Academy of Family Physicians and the American Osteopathic Association endorsed the House's healthcare reform bill this week, though both groups link their endorsement to the passage of a separate bill to address Medicare payments.