The big goal of health care reform is to cut wasteful spending to pay for expanded health insurance coverage.

But the way the Senate Finance Committee bill tries to do that would be, according to some doctors, “disastrous.”

The bill would require all physicians to participate in Medicare’s Physician Quality Reporting Initiative by 2012 and then, in 2014, use those reports to cut Medicare reimbursement 5 percent for any doctor whose level of testing and procedures is in the top 10 percent of all doctors in his or her field.

Sallay

The concept of the bill is good, said Dr. Peter Sallay, managing partner of Methodist Sports Medicine in Indianapolis, but the execution is bad.

Sallay and other physicians worry that the government will not be able to collect the data needed to draw a distinction between doctors who order excessive tests and procedures and those who do lots of tests and procedures because they see the sickest and poorest patients.

The Senate Finance bill calls for the Medicare program to collect health status and demographic data to account for those differences. But in the past, the government has acknowledged it has been unable to do so adequately.

Health insurers have tried and failed to do the same, noted Stacy Cook, a physician attorney at Barnes & Thornburg LLP in Indianapolis.

“It’s just something that’s extremely difficult,” she said. “It’s something that I don’t think has successfully been done.”