A Medical Device Daily
The Medicare funding bill has raised probably more hackles than any other healthcare financing bill this year with the exception of the bill for the Children's Health Insurance Plan, but one of the differences is that Congress resoundingly overrode the White House's veto of the former.
By a vote of 383-41, the House of Representatives blew past the veto Tuesday after picking up 28 additional votes, and the Senate followed suit, overriding the Bush veto by 70-26. Senate supporters increased by four all of them members of the GOP but Sens. Barack Obama (D-Illinois), John McCain (R-Arizona), Ted Kennedy (D-Massachusetts) and John Warner (R-Virginia), all missed the vote for varying reasons.
The override of the veto will reverse the scheduled 10.6% cut to physician pay under Medicare Part B for the next 18 months and boosts payments by 1.1% next year. However, this is achieved by cutting payments to Medicare Advantage plans to the tune of $12.5 billion over five years. This funding mechanism lay at the heart of the conflict between the two parties over the bills.
Another feature of the bill is that it slaps an 18-month hold on the bidding program for durable medical equipment, which is thought to offer potential savings of $1 billion a year.
In a statement, Senate majority leader Harry Reid (D-Nevada), said, "we wasted no time in reversing the president's carelessness and protecting our nation's doctors and the patients they treat and this responsible and overdue Medicare fix is now law." However, the Senate's Jon Kyl (R-Arizona), said the bill "reduces patient access and choices," criticizing Democrats for elbowing aside an alternative bill that had been under negotiation between Max Baucus (D-Montana) and Chuck Grassley (R-Iowa), the chairman and ranking member, respectively, of the Senate Finance Committee.
Unfortunately for Congress, the Part B doc fee fix will arise again in 18 months because the measure does not deal with the sustainable growth rate (SGR) mechanism, leaving a potential rate cut of 20% to overcome in 2011.
Rep. Pete Stark (D-California), the chairman of the health subcommittee of the House Ways and Means Committee, acknowledged in a statement that Congress is "just kicking the can down the road," adding, "none of us ... have any idea how we are going to solve the physician reimbursement issue."
In a July 15 statement, Nancy Nielsen, MD, President of the American Medical Association (AMA; Washington), said the cuts to doc fees "would have been devastating to seniors and the disabled who rely on Medicare for the healthcare they need, as well as to military families who rely on Tricare for their healthcare." Nielsen also said that the debate "underscores the need for lawmakers to permanently replace the flawed Medicare physician payment formula so physicians can focus on the real work at hand: taking care of patients."
NIH says yes to high-tech equipment
Medical technology benefits from a lot of private-sector investment, but the National Institutes of Health, with its $30 billion annual budget, has pockets of its own. NIH recently authorized a round of awards to research centers that will put the latest technology in the hands of medical researchers, hopefully driving basic research into cures for the clinic.
In a July 16 statement, NIH reported that it has awarded more than $33 million to 20 parties for research under the High-End Instrumentation (HEI) grants program, which is dedicated to such efforts that require at least $750,000 to fund.
Among the beneficiaries of the awards is Florida State University (FSU; Tallahassee), which will obtain a pair of the latest robotic electron microscopes, which will be used to provide rapid 3-D imaging of interactions between individual proteins and the components within living cells. These microscopes can be operated remotely 24 hours a day and will provide data on heart disease, cancer and HIV/AIDS.
Barbara Alving, MD, the director of the National Center for Research Resources at NIH, said in the statement, "tools such as these play key roles in the study of disease and the fundamental mechanisms of biological function, ultimately leading to new advances and treatments for diseases."
Another academic research center, the University of Wisconsin/Madison (Madison, Wisconsin) will install "a unique integrated liquid chromatography, mass spectrometry, and NMR (nuclear magnetic resonance spectrometer) system" that will boost research into biomarkers. The University of Pittsburgh (Pittsburgh, Pennsylvania) will pick up "the latest hybrid imaging technology a new system that combines positron emission tomography (PET) with magnetic resonance imaging," according to the NIH statement. Researchers there hope to learn more about neurodegenerative states such as Alzheimer's disease.
According to NIH, any institution seeking HEI awards "must identify three or more NIH-funded investigators whose research requires the requested instrument" and must fund any buildings or building renovations to support the equipment. Maintenance services are also on the receiving institution's budget, and the maximum award is said to be $2 million.