Fiscal Cliff Deal of No Help to Patients or Physicians
Jan 2, 2013
After the 11th-hour fiscal deal that postponed Medicare physician fee cuts slated to occur under the Clinton/Gingrich sustained growth rate (SGR) formula, the Association of American Physicians and Surgeons released the following statement:
“The Medicare SGR cut is one of those promised spending cuts that never occurs. Each year the proposed cut grows larger, and each year it is postponed after a ritual game of ‘Chicken’ between Congress and the AMA. The AMA states, correctly, that many physicians could not afford to take care of Medicare beneficiaries if their fees were cut. In fact, a 30% cut in fees means a much larger cut in pay because the fee has to cover overhead.
“However, no ‘SGR fix’ is going to solve the problem of access to care. Physicians cannot continue to serve their patients under a regime of price controls and costly, byzantine regulations, in an atmosphere of constant uncertainty and draconian threats.
“The AMA has not and will not propose a solution because a major source of its revenue is the CPT coding system used for administering the price controls. Congress is unwilling to confront the reality that Medicare is bankrupt and unsustainable. It has made more than $50 trillion in promises without any way to pay for them.
“Physicians who want to continue serving Medicare patients, without increasingly severe covert rationing, need to opt out of Medicare or disenroll. If the physician opts out, patients must forgo Medicare benefits for his services. If he disenrolls, patients might or might not be able to collect benefits to which they are entitled, but the doctor may be threatened with a $2,000 fine for each instance of refusing to file a claim to collect taxpayers’ money.
“The only way patients can see a Medicare-enrolled physician without the restrictions imposed by the program is to decline Part B. Unfortunately, the market for comparable private coverage was destroyed by President Johnson in 1965, and the cost of re-enrolling in Part B can be substantial. However, self insurance for physicians’ services is feasible: patients could set aside the monthly Part B premium and the premiums for ‘supplemental’ coverage, which can be very limited but very costly. Without the huge Medicare overhead, many physicians have been able to reduce their fees substantially.
“A huge entitlement cliff looms. Patients and physicians need to work together to preserve private care, as the government program runs out of money.”
The Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, was founded in 1943 to promote the practice of private medicine.