We are now approaching the perennial pre-holiday panic to fix the Medicare payment system for physicians. Unless Congress acts before January 1, 2012, doctors will see deep cuts, up to 27.2%, in their payments from Medicare. The cuts derive from a 1990’s budget law that intended to control Medicare spending by mandating a payment formula for physicians based on the idea that physicians can control all of Medicare’s spending. The law stipulates that if overall Medicare spending rises more than a certain amount, physicians would in turn see their payments cut by a certain percentage. This type of macro-policy lever is theoretically attractive. However, it does not work in the real world in which we live. Congress has known this for years. But it has done nothing to remedy the issue by replacing this broken law with a new law that actually works. Why? Because to fix the problem on a permanent basis would require $300 billion unbudgeted dollars over the next ten years. Oh my goodness, the national debt is now actually $15.3 Trillion vs $15.0 Trillion! Yes it is!
Nobody in Congress (with the power to bring a majority of followers from both Houses) has the courage to admit we have a failed Medicare physician payment system, not to mention a pending bankruptcy of the entire Medicare program. President Obama and leaders of Congress could have fixed the problem two years ago as part of the massive health care overhaul. They did not. It would have added $250 Billion (at that time) to the cost of the Affordable Care Act (ACA). That would have sunk the ACA with all of its enormous…and totally unrealistic promises. That was not going to happen. Put the matter to the side. Kick the can down the road. Continue to live in fantasy land.
The problem could be remedied even now, by making other changes to Medicare, some fairly significant, that would save dollars that could then be used to pay physicians adequately! Physicians might also have to take a partial pay cut, if only to contribute their share. This will not happen. No leadership, no will, no courage.
Medicare’s problems grow larger by the day. It is a scary sight to see. So much promised but so little to back it up. The Medicare Trust Fund is set to go belly up within a decade. The only real hope we now have is for a new Congress and a new President to fix the Medicare Doc Fix problem, along with the rest of the crashing Medicare program. The 2012 Elections cannot get here quickly enough.
Dr. Winkenwerder on Fox Business News on November 29, 2011 – No Political Will to Fix Medicare Issues
Yahoo Finance – Medicare Back on the Brink Over Cuts to Doctors – Dated: November 28, 2011