Medicare back on the brink over cuts to doctors

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Medicare back on the brink over cuts to doctors

Back on the brink: Doctors again face steep Medicare cuts unless Congress acts

before Jan. 1

By Alonso-Zaldivar, Associated Press | AP – 1 hour 24 minutes ago

WASHINGTON (AP) -- Politicians of both parties outdo each other vying for the

approval of seniors, but their inability to compromise on the federal budget has

put Medicare in the crosshairs again.

Unless Congress acts before Jan. 1, doctors face a 27 percent cut in their fees

for treating Medicare patients. That could undermine health care for millions of

elderly and disabled beneficiaries.

Last year around the holidays doctors were looking at a cut of about 20 percent.

It's become a recurring symbol of the government's budget dysfunction.

The cuts are the consequence of a 1990s budget law that failed to control

spending but never got repealed. Congress passes a temporary fix each time, only

to grow the size of reductions required next time around. The supercommittee's

breakdown leaves the so-called " doc fix " unresolved with time running out.

A thousand miles away in Harlan, Iowa, Dr. Don Klitgaard is trying to contain

his frustration.

" I don't see how primary care doctors could take anywhere near like a 27 percent

pay cut and continue to function, " said Klitgaard, a family physician at a local

medical center. " I assume there's going to be a temporary fix, because the

health care system is going to implode without it. "

Medicare patients account for about 45 percent of the visits to his clinic.

Klitgaard said the irony is that he and his colleagues have been making

improvements, keeping closer tabs on those with chronic illnesses in the hopes

of avoiding needless hospitalizations. While that can save money for Medicare,

it requires considerable upfront investment from the medical practice.

" The threat of a huge cut makes it very difficult to continue down this road, "

said Klitgaard, adding " it's almost comical " lawmakers would let the situation

get so far out of hand.

There's nothing to laugh about, says a senior Washington lobbyist closely

involved with the secretive supercommittee deliberations. The health care

industry lobbyist, who spoke on condition of anonymity because he is not

authorized to make public statements, said lawmakers of both parties wanted to

deal with the cuts to doctors, but a fundamental partisan divide over tax

increases blocked progress of any kind.

The main options now before Congress include a one-year or two-year fix.

The problem is the cost. Congress used to add it to the federal deficit, but

lawmakers can't get away with that in these fiscally austere times. Instead,

they must find about $22 billion in offsets for the one-year option, $35 billion

for the two-year version. A permanent fix would cost about $300 billion over 10

years, making it much less likely.

" It's going to be a real challenge, and there's not a lot of time to play

ping-pong, " said the lobbyist. " It's entirely possible given past performance

that Congress misses the deadline. "

Congressional leaders of both parties have said that won't happen. Senate

Finance Committee Chairman Max Baucus, D-Mont., says the Medicare fix is too

important not to get done before the end of the year. His House counterpart,

Ways and Means Chairman Dave Camp, R-Mich., agrees. But how? The endgame for a

complex negotiation also involving expiring tax cuts, unemployment benefits and

dozens of lesser issues remains unclear.

" They have to come up with a solution, and they will have to appear to pay for

that solution, and that will be contentious, " said economist Reischauer,

one of the public trustees who oversees Medicare and Social Security financing.

One option: cut other parts of Medicare. Another: trim back spending under the

health care overhaul law. Either of those approaches would mobilize opposition.

A nonpartisan panel advising lawmakers is recommending that doctors share the

pain of a permanent fix with a 10-year freeze for primary care physicians and

cuts followed by a freeze for specialists. Doctors aren't buying that.

The Obama administration says seniors and their doctors have nothing to fear.

But doctors are becoming increasingly irritated about dealing with Medicare.

Surveys have shown that many physicians would consider not taking new Medicare

patients if the cuts go through. Some primary care doctors are going into

" concierge medicine, " limiting their practice to patients able to pay a fee of

about $1,500 a year, a trend that worries advocates for the elderly.

Ultimately, the solution is an overhaul of Medicare's payment system so that

doctors are rewarded for providing quality, cost-effective care, said Mark

McClellan, an economist and medical doctor who served as Medicare administrator

for President W. Bush. That continues to elude policymakers.

Instead, the threat of payment cuts has become a holiday tradition, said

McClellan. " It's just not a very enjoyable one. "

[Guest guest]

This isn't the only incidence of government playing this game. Its just disgusting with the vermin up there playing games for power while the system is collapsing. Its just a pity that while Republicans had solid majorities in both houses and Bush in the White House, they didn't handle these and other things and control spending. Instead, they grew spending and created more programs while allowing important things to go untended. Perhaps they were too busy kowtowing the Ted Kennedy and trying to gain the approval of senior Dems. Lot of good being "Bipartisan" did since the Dems, once they had the power, shut them out completely.

In a message dated 11/28/2011 1:29:09 P.M. Eastern Standard Time, no_reply writes:

The cuts are the consequence of a 1990s budget law that failed to control spending but never got repealed. Congress passes a temporary fix each time, only to grow the size of reductions required next time around. The supercommittee's breakdown leaves the so-called "doc fix" unresolved with time running out.