Home Contact Register Subscribe to the Beacon Login

Wednesday, April 07, 2010

DENNIS PATRICK: MEDICARE’S DOCTOR FEE CUT

Effective April 1, 2010, a 21% fee cut in Medicare reimbursement to doctors went into effect.

While senators and congressmen on Easter vacation fanned out across the country selling the wonders of their health care handiwork, seniors remained concerned that congress failed once again to solve Medicare’s cut to doctors’ fees.

Here’s the recent congressional track record on the doctor fee fix. Cuts in the doctor payment rates have been deferred for years. Until deferred by congress, recent cuts were to go into effect in October 2009, then January 1, 2010, then February 28. However, because congress did not act before the most recent deadline, the rate cuts are now in effect as of April 1.

Congress created the problem originally. Here’s the background. Law requires Medicare payment rates to adjust each year for inflation -- except for doctor services. Doctor rates are set by a complicated mechanism established in 1997 called the Sustainable Growth Rate (SGR) formula.

SGR is an ill-conceived archaic cost control measure. It establishes artificial “spending targets” (price controls) for annual health care expenditures based on the US Gross Domestic Product (GDP). If costs exceed the artificially set targets, doctor rates are cut. Incredibly, the GDP has no relation to the cost of doctor services or the actual cost of delivering health care.

Although congress has overridden the doctor fee cuts in the past, as they must do by law to prevent the cuts from going into effect, they are not obligated to intercede on a continuing basis. This year, congress did not act decisively in time to block the fee cut and consequently the cut went into effect on April 1 where it remains.

Knowingly using this flawed formula is unconscionable. The compounding problem will result in a cumulative fee cut of 25% in 2011.

In the past, “patches” were occasionally legislated retroactively, but that served only as a temporary fix. Supposedly, early in the second session of the 111th Congress, a “patch” will be enacted retroactively. It’s anybody’s guess why congress doesn’t come up with a permanent fix. They just keep kicking the can down the road.

How long will doctors live with congressional brinkmanship? How long will doctors rely on Medicare to pay them not knowing when or how much? Increasingly doctors no longer accept new Medicare patients. How long before doctors solve their problem by turning away existing Medicare patients as well? Or, simply terminate their practice altogether?

Even the much touted nonpartisan Congressional Budget Office confirms that continued reduction in doctor Medicare reimbursements will reduce beneficiaries’ access to medical care.

Medicare is just the tip of the iceberg. Congress typically keeps putting off a permanent fix in other areas. This is true of the way congress handles inefficient government programs like Social Security, the US Postal Service, Amtrak, Fannie Mae and Freddie Mac. We’ll all grow old waiting for accountability from congress.

Congress should have focused on substantive health care issues such as the doctor fee travesty and solved it once and for all rather than overhaul the entire health care system to the detriment of the large majority.

Pushing for universal health care rather than solving existing problems, President Obama has demonstrated that he is a radical governing from the left. Unbelievably, North Dakota’s congressional delegation, wittingly or not, follows his lead.

If our congressional delegation won’t solve straight forward problems like the doctor fee enigma, what good are they? What purpose do they serve?

Is it time for regime change?

 

Click here to email your elected representatives.

Comments

No Comments Yet

Post a Comment


Name   
Email   
URL   
Human?
  
 

Upload Image    

Remember my personal information

Notify me of follow-up comments?