Florida Medical Assn., AARP turn up heat on Martinez

Florida Health News–July 7, 2008

By Carol Gentry

When Congress reconvened Monday after a week off, Florida Sen. Mel Martinez was under heavy pressure from Florida AARP and the state medical association to drop his opposition to a bill that would shield doctors from a steep Medicare pay cut. As the New York Times reported, Republicans nationwide are feeling the heat. The Florida alliance of AARP and FMA is a case of strange bedfellows, since they’re often on opposite sides of political issues.

More than 10,000 Florida AARP members have called or written Martinez’ office in protest of the 10.6 percent pay cut that took effect July 1,  said Jeff Johnson, AARP manager of the state’s Divided We Fail campaign. Martinez is in the doghouse with AARP because a motion to proceed with a bill to prevent the cut fell just one vote short before the recess for the July 4th holiday. “We’re trying to let him know we think this is important,”  Johnson said.

Meanwhile, Florida Medical Association has coordinated an effort to get its members to thank Sen. Bill Nelson, D-FL, for his support of the legislation, and to funnel their message of frustration to Martinez. “They’re saying, ‘You’re going to lose our support,’ said Fred Whitson, FMA director of medical economics.

In the past, the medical association and AARP have not always seen eye-to-eye. But they agree this time that Martinez’ refusal to trim payments for Medicare Advantage health plans — proposed as the source of funds to prevent the doctors’ pay cut — is unacceptable, given that several independent studies have pegged the health plans’ overpayments at 12 percent or more.

“In some ways, we make strange bedfellows,” Whitson said, “but in this one issue, the goals are the same.”

Rather than implement the pay cut and trigger a medical revolt, the Centers for Medicare and Medicaid Services has placed a temporary freeze on payments to doctors until July 15, as Florida Health News reported last week.  By that time, CMS hopes that the bitterly divided Senate will have reached an emergency compromise.

Sen. Martinez has thrown himself into that effort, said his spokesman Ken Lundberg. “He still supports a doctor fix, but not at the expensive of Medicare Advantage,” Lundberg said. “He’d like to see a permanent fix.”

Every few months since passage of the Medicare Modernization Act of 2003, Congress has postponed the day of reckoning for implementation of that act’s revision to the physician payment system — the SGR, or sustained growth rate. Because it did not give enough weight to medical inflation, doctors say, the SGR had the effect of cutting their pay. Each postponement of the implementation has deepened the potential cut, until it reached 10 percent. In Florida, where a large proportion of the patients are insured through Medicare, many doctors say they would not be able to keep their doors open if they sustained a cut of that magnitude.

Lundberg said the Senate could have resolved the issue if the Democrats, sensing a political opportunity to make hay with senior voters and medical groups, hadn’t left the pay cut until the last minute before the July 1 recess. Senate Majority Leader “Harry Reid would rather have a political issue than a solution,” Lundberg said.

While doctors and patients know there is political grandstanding going on, AARP and the medical association says, they believe it runs both ways. Now that it’s come down to a popularity contest between doctors and insurance companies, patients and the groups that represent them are tending to side with their doctors.

It’s too early to tell whether the Republican party, which has enjoyed financial backing from medical groups in years past, will pay a price, Whitson said. Tampa surgeon Michael Wasylik, a state leader in medical economics issues, says he’s not sure. Physicians were at first suspicious of Martinez, since he’s an attorney, but the senator won them over by voting for lawsuit reforms and other issues crucial to doctors, Wasylik said.

But Martinez couldn’t go with the medical groups this time because of President George W. Bush’s firm commitment to protect the insurance plans from any cuts. Bush has vowed to veto any cuts to Medicare Advantage plans, saying that they would ultimately hurt patients.

Martinez “is going to do what George Bush tells him to do,” Wasylik says. “He always has.”