The Medicare Payment Advisory Commission (MedPAC) is about to get a promotion. MedPAC is the independent congressional agency that advises Congress on Medicare payments/reimbursements. Up till now, MedPAC's suggestions were just that; suggestions to be implemented or ignored by Congress. According to the Washington Post, President Obama is considering two options that would grant MedPAC more power. The first is a resolution from Jay Rockefeller which would move MedPAC into the executive branch. This would make MedPAC a de facto autonomous agency that could unilaterally set Medicare payment schedules and fund policy initiatives. (This is the vaunted "Federal Reserve" of healthcare envisioned by Tom Daschle.) The second would simply allow MedPAC to fast track their recommendations through Congress without the possibility of filibuster or amendment.
Either way, we're looking at a small agency that is about to assume the command post of how we determine reimbursement for physicians and other health care providers. Taken alongside rhetoric of "health care reform is entitlement reform", this sort of development ought to be frightening for any practicing physician. Here's $150 for that gallbladder you did at 2am, Dr. Parks. Nice doing business with you. Thanks for helping America get back into the black!