Blog: Two GOP lawmakers put SGR in their death pool

According to two influential GOP lawmakers, doctors will not have their Medicare pay cut by around 30% in January as called for by the sustainable growth-rate reimbursement formula. However, the lawmakers differ on when the much-hated SGR will be repealed for good.

Both Rep. Paul Ryan of Wisconsin, the party's presumptive vice presidential candidate, who finished No. 24 on Modern Healthcare's 2012 Most Influential People in Healthcare list, and Sen. Chuck Grassley of Iowa, No. 56 on the list, seemed certain that another temporary fix will be approved by Congress and signed by President Barack Obama before the scheduled pay cut kicks in.

"No one is going to go home to their state to tell doctors we're cutting their pay 30%," Grassley said during an interview with Modern Healthcare for the Most Influential list.

Ryan, who finished first on the Most Influential list last year, said not only that he thinks another temporary patch will be approved, but also that he has hopes a permanent replacement—that produces predictable and accountable pay rates—will be approved in 2013.

"I think the SGR is ridiculous and should have been replaced long ago," said Ryan during his Most Influential interview, adding that a replacement needs to be passed so that "we don't have this can-kicking exercise every six months."

Grassley's hopes for replacing the SGR were not as high.

"First of all, we all ought to be embarrassed that we didn't see it wasn't a very effective formula," Grassley said, adding that Congress had misplaced confidence in those that advocated for including the SGR in the Balanced Budget Act of 1997.

For all of the formula's faults, Grassley said, replacing the SGR will need to be part of a major overhaul in the U.S. healthcare system, so it might be around for a while.

"Until we move completely from what we're doing now—a system of medicine based on services—to a system based on quality and accountability, we'll have the SGR," Grassley said.

Grassley's placement at No. 56 was his lowest finish ever on the Most Influential list, but it still placed him in an elite group of only eight people who have made the list in all 11 years of its existence. The only elected official on the "perennial" roster, Grassley had his highest ranking in 2009, when he placed No. 5 on the list.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.



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