Doctors' Health Care Reform ‘Wish List’

HOUSTON - On the heels of the Republican victory in Massachusetts, President Barack Obama and his congressional allies say they’ll scale back their efforts to overhaul health care.

A less-ambitious bill is emerging as an alternative, now that the Democrats have lost their filibuster-proof Senate supermajority.

And now that it appears to be “back to the drawing board” on health care, local doctors are weighing in on what would like to see, and not see, in any revamped bill.

The Senate bill that passed on Christmas Eve would reduce the ranks of the uninsured by adding about 34-million of them to the Medicaid rolls.

And some doctors say that is a problem, not a solution.

“Since Medicaid is a cooperative federal/state program,” says Robert Luedecke, MD, with Doctors For America, “a lot of states may not have the money to fund more people in their state.”

Other physicians simply won’t accept Medicaid patients because of the program’s low reimbursements.

“If you insure everybody in the country,” says Kevin Smith, MD, “and doctors decide, ‘because of reimbursements, we don't accept your insurance,’ then you have the real crisis of access.”

Many doctors are hoping any new bill will help solve their billing issues.

William Gilmer, MD, the incoming president of the Harris County Medical Society, says government programs require certain codes for proper billing, while private insurance companies use completely different codes.

Hefting two large manuals on his desk, he says, “These are two books of rules for Medicare, for coding.”

The books list thousands upon thousands of numerical codes that identify certain medical procedures. The proper codes must be submitted so the physician can collect payments.

“There are people who go to college to get a degree in coding,” says Dr. Gilmer. “I want to take care of patients.”

And there’s another thing on the doctors’ wish list, something Republicans have supported in the past: a provision that would discourage frivolous lawsuits.