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Title : What Produce Nosotros Request To Produce To Possess The Medicare Doctor Payment Problem?
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What Produce Nosotros Request To Produce To Possess The Medicare Doctor Payment Problem?

Whenever the dependent area of Medicare physician fee payments comes upward on this blog, the reaction from physicians, especially primary attention docs, is predictable: "You can't cutting us, nosotros haven't had a Medicare enhance inwards years, nosotros are already dramatically underpaid, too if Medicare cuts our payments nosotros are going to stop taking Medicare patients."

There is no incertitude that doctors accept a point--particularly the primary care folks. Influenza A virus subtype H5N1 huge occupation is that the payment remainder betwixt chief attention too specialty attention has gotten way out of whack every bit both private too populace payers accept tended to lump the 2 categories of physicians together. This has been going on for too hence long that it is also leading to a growing shortage of chief attention physicians.

There is also no incertitude that Medicare is financially unsustainable on its acquaint rail too that applies to all categories of health plans--public too private.

The Sustainable Growth Rate (SGR) formula is obviously non working--just the fact that the Congress keeps overriding it speaks for itself. But inwards concept, it did accept a legitimate objective.

Congress created the SGR inwards 1997 every bit it became clear Medicare costs could non last sustained. The persuasion was to laid an "affordable" physician terms tendency and when existent costs exceeded that grade Medicare would compensate for it past times cutting time to come fees.

The SGR message to doctors was simple: If you lot pass likewise much the Medicare computer program volition compensate past times cutting your fees inwards the time to come to remainder things out. The objective was to give physicians a argue to command their costs.

As nosotros right away know, the Congress did a "never mind" every fourth dimension a cutting was required nether the formula.

Maybe the SGR was likewise broadly targeted. Maybe the target should haven been broken downwards amongst a focus on primary versus specialty, or fifty-fifty past times each specialty. Maybe it was an unrealistic persuasion inwards the kickoff place. Maybe the fact that it was never enforced spoiled its intent. Maybe it was unrealistic to recall the docs actually had whatsoever command inwards the kickoff place. Maybe nosotros should exactly give the docs a blank check.

What is happening to Medicare and physicians also can't last seen inwards a narrow context--the same issues plague Medicaid, SCHIP, too the commercial market. Costs for hospitals, drugs, durable medical equipment, too everything else is also on the same unsustainable track.

But to all the physicians who post service on this spider web log amongst the full general message "you can't cutting us," at that topographic point may last a lot of truth to that but of course of didactics it's a lot to a greater extent than complicated than that. Medicare--and every other program--is only unsustainable inwards its electrical flow form.

While it is truthful that everyone else inwards the arrangement carries guilt--like insurance fellowship overhead, cost insensitive patients, drug fellowship behavior, too on too on, pointing the finger at the other guy doesn't count for the sake of this conversation--those are all legitimate issues but also supply a arrive at for physicians not dealing amongst their ain issues here.

So, what is the answer?

"If you lot impact me I volition abandon my senior patients," is non an answer. That's exactly a threat--and an unrealistic i at that. Even amongst a bargain this calendar month to defer the cuts, the SGR already has an automatic 21% cut laid to occur on Jan 1, 2010--the occupation is literally growing at an exponential rate. Stalemate on all of this exactly agency physicians have to alive amongst the electrical flow mess indefinitely.

Where does the physician payment problem become from here?

This month's grapple over Medicare physician fees: Run For the Hills, the Doctors Are Coming, the Doctors Are Coming!!!!

Earlier post: There Won't Be Any Health Care Reform Without Physician Payment Reform too There Won't Be Any Physician Payment Reform Unless the Docs Lead The Way

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