Stanley Feld M.D.,FACP,MACE
Last year’s “Doctor Fix” was passed the last week congress was in session in 2010. This was after the medical profession was held in suspense for 9 months.
The “Doctor Fix” was supposedly the result of President Obama making a deal with the AMA for the AMA’s support. He was going to pass a real “Doctor Fix” in 2011 by repairing the defective sustainable growth rate formula (SGR). Nothing has been done about this by President Obama in 2011. The cumulative physician reimbursement reduction of 25% was suspended until January 2012.
Physicians face a 29.5% Medicare Pay Cut in January 2012. Four and one half percent was added to last year’s cumulative physicians reimbursement reduction. The reduction was calculated into the CBO’s cost score for President Obama’s Healthcare Reform Act.
Last week an official with the Centers for Medicare and Medicaid Services unveiled the 29.5% rate reduction for 2012 in a recent letter to the Medicare Payment Advisory Commission. This will become another distraction for physicians and the media as President Obama stalls for time.
“Leaders of the American Medical Association and other medical societies have warned that such a huge pay cut would force physicians to turn away not only seniors but also military families whose TRICARE coverage is based on Medicare rates.”
President Obama is stalling for the development and implementation of Accountable Care Organizations. His goal is to deal with big hospital systems, clinics, and not 600,000 individual physicians.
President Obama is ignoring the fact that Accountable Care Organizations (ACOs) are difficult to organize and impossible to execute efficiently and effectively. ACOs will fail for the reasons I have outlined previously.
It will end up costing the federal government more rather than less than the present system does. Hospital systems are excited because they think they will own the physicians and make a killing on Accountable Care Organizations. They think they will own physicians intellectual property. They cannot be more mistaken. They can expect a lot of fighting and grief.
At the same time, President Obama is dispiriting the physician workforce with his duplicity. He is increasing physician mistrust for government control over medicine.
President Obama’s proposed budget for fiscal 2012 calls for delaying the next cut from January 1, 2012, until January 1, 2014, freezing rates in the meantime.
Why doesn’t he fix the SGR? It is a screwy way to do business.
The healthcare system needs to be repaired. President Obama is going about it the wrong way.