According to the Wall Street Journal, although Medicare payments to doctors were supposed to fall by 21% at the start of this year, Congress passed a last-minute, two-month patch to block the cuts. WSJ also noted that another possibility for fixing Medicare payments is a five-year patch, which the President included in his budget could be on the way.
Typically, Congress passes legislation each year to provide a one year patch of Medicare pay cuts to doctors. Groups such as the AMA and the AARP “want Congress to permanently repeal the payment formula that keeps calling for the cuts,” and to come up with a new long-term solution. In the past, proposed legislation to permanently block the “cuts have failed in the Senate, in large part because senators couldn’t figure out how to pay for it.”
Many have noted however, that to repeal the payment formula, the “nation will spend hundreds of billions more on Medicare over the next decade.” With an aging population, and a significant increase in Medicare enrollees, the prospect of spending billions more is pretty much inevitable. Such a consequence should not come out of the cost of doctor’s pockets who are already facing high expenses for insurance, administrative resources, and other costs to stay afloat.
One factor that will contribute to the final decision on how to deal with the payment formula is that “the Senate recently passed a pay-as-you-go law that would require balancing all new spending with tax increases or spending cuts.” Contrary to the name itself, “the Hill noted yesterday, that the legislation included a loophole of sorts: Congress can allocate an additional $82 billion for physician payments without having to find new sources of revenue or savings.”
According to the article, that kind of money cannot eliminate the payment system, “but it could be enough to block scheduled pay cuts for five years.”
It should be important for all politicians and legislators to find a bipartisan way to approach a new form of payment system for physicians who see Medicare patients. With the potential of health care reform adding millions of new people to the health care system, a dwindling number of doctors retiring and entering into primary care, the last thing the health care system needs it to neglect physician pay. While there are many ideas being proposed to offset costs for Medicare such as rooting out fraud and abuse, comparative effectiveness, and the use of generics, the cost of physician service cannot be sacrificed or else the quality of care is soon to follow.