Let's Make a Deal: Doctor Support for Government Contracts

article top

So why don’t President Barack Obama and Speaker Nancy Pelosi want to allow CSPAN to televise the final health care negotiations? Why is White House press secretary Robert Gibbs evading questions about transparency in the final crafting of the bill? Just what deals are being made to secure the votes necessary to pass a plan that vast majorities of the American public are against?

It appears that medical groups supporting Obamacare could come away with healthy bottom lines. Dr. Erik Dahl blasted the American Medical Association’s recent support of the Senate health care bill, noting that the physicians group failed to mention the medical billing system it has with the Health and Human Services Department.


Writing in The Wall Street Journal, Dahl, a Maryland doctor and a former assistant chief at Walter Reed Army Medical Center, posits in a letter to the editor:

‘[While] Democrats are touting the AMA’s endorsement, little has been reported in the media that a large portion of the AMA’s income (the exact amount will not be released by the AMA) stems from the exclusive rights to the medical billing codes that doctors are required to use when they submit bills to insurance plans.’

‘These are essentially the same as a bar code, and are used for nearly every medical procedure, from appendectomies to heart transplants. This arrangement results from a once-secret deal established in the 1980s whereby the AMA maintains and updates the codes at no cost to the government, but generates millions each year selling the code books and software licenses to doctors and insurers. This enabled the government to streamline billing procedures for its insurance programs by setting a single code as the standard.’

Pointing to a growing number of state medical societies that have come out against Obamacare, Dahl continues: “The AMA touts its proof of supporting doctors in that it is working to abolish the 21% Medicare payment cut to physicians scheduled for the coming year. However, we all know this would never take place, as millions would be dropped from the Medicare rolls. This is the reason only 17% to 19% of physicians belong to the AMA, and this number is dropping.”

In addition to the AMA’s ties with the government, a small group of influential hospitals appear to have received a little-known provision in House and Senate legislation that would allow them to gain millions in Medicare funding. The Washington Post reports that language in both bills “would reward hospitals in their Medicare spending, a dramatic change in the formula for parceling out the public dollars, which can account for as much as half of a hospital’s budget.”

“That could prove to be a windfall for some hospitals but a significant loss of funding for others, mostly those in big cities and the South,” the article says.

The Mayo Clinic, a health care reform darling of the Obama administration, led the group of hospitals that lobbied for the revised Medicare formula payment change. Not surprisingly, the group was supportive of the Senate health care bill.

‘Marguerite Higgins wrote this for Heritage.org’