'Jobs' bill deals with leftover costs from Obamacare 

One of the costliest components of a $190 billion bill advertised as a "jobs" bill is a provision that would forestall a 21.3 percent reduction in Medicare physician payments that is scheduled to take effect next month.

At a cost of nearly $65 billion, the "doc fix" measure, as it has been nicknamed, would stave off such Medicare cuts for the next three years. Typically, Congress has voted to prevent these cuts on an annual basis, even though they were built into the system as a way to keep the cost of treating Medicare patients from getting out of control.

This year, lawmakers promised doctors a long-term fix if they would back the Democratic health care reform bill. Initially, this expenditure was included in President Obama's $1 trillion national health program, but it was stripped out in order to keep the bill from adding $59 billion to the deficit.

Now it comprises nearly one fifth of the cost of the jobs package.

Ironically, this latest fix lacks the enthusiastic backing of the American Medical Association. According to the AMA, the formula that calls for the cuts, known as the Medicare Sustainable Growth Rate, is flawed and needs to be completely revised to prevent even bigger cuts in three years, when the current fix expires.

But there is little political will to repeal this formula because it would cost tens of billions, if not hundreds of billions of dollars.

"Lawmakers must realize that the underlying policy problem will return larger than ever in 2014," James Rohack, president of the AMA, warned.


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