A coalition representing over 240,000 surgeons on Wednesday signaled they opposed Senate Democrats' healthcare bill in its current form.

The American College of Surgeons and 18 other medical societies representing surgeon specialists stressed they could not support that proposal because it inadequately addressed Medicare's doctor payment system, included a overly powerful Medicare payment-setting commission and created a new, unfair cosmetic surgery excise tax.


"As you may recall, on November 4 our coalition sent you a letter outlining a number of serious concerns that needed to be addressed...," the surgeons wrote in a letter to Senate Majority Leader Harry Reid (D-Nev.). "Since those concerns have not been adequately addressed, as detailed below, we must oppose the legislation as currently written."

According to the surgeons, the Senate healthcare bill does not include a long-term "doc fix" that regulates the rates Medicare pays participating hospitals and physicians. While Senate Democrats have stressed they will tackle that reform soon, the system as it stands is "broken," wrote the surgeons, hamstringing Medicare.

Additionally, the surgeons fear the proposed Independent Medicare Advisory Board, which will determine reimbursement rates, could implement its own recommendations "without congressional action." They also labeled the cosmestic surgery tax as discriminatory against women and the middle class, and they predicted it would "not result in the projected revenue."

The surgeons did, however, approve of a few of the bill's provisions, notably its health insurance market reforms and elimination of rules that keep patients who have pre-existing conditions from soliciting insurance. Still, the coalition stressed it could not support the entire bill until Democrats sufficiently addressed their litany of grievances.

"We are committed to working with you to make critical changes that are vital to ensuring that this legislation is based on sound policy, and that it will have a long-term positive impact on patient access to safe and effective high-quality surgical care," they wrote.