By Robert Hughes
Now that the election has passed, policymakers from both sides of the aisle must get past the politics of the health care reform law and begin to have serious discussions regarding the changes needed to truly preserve access to care for our patients in the future.
One of these critically needed changes is protecting our seniors’ continued access to timely needed care by preventing staggering cuts in Medicare payments to the physicians who are providing this care. This is one of the most important issues to be addressed as Congress and President Obama negotiate to prevent the “fiscal cliff.”
Unless action is taken by Congress, once again physicians face a draconian 27 percent cut in their Medicare payments on Jan. 1, just a few weeks away. They face even further cuts as a result of the mandatory sequestration provisions contained within the Budget Control Act of 2011.
These cuts are driven by a flawed formula called the Sustainable Growth Rate, which penalizes physicians by lowering their payments when growth in the use of medical care exceeds that of the gross domestic product. This is done despite the fact that service use is driven by factors outside physician control, such as patient health needs, emerging technology and public policy changes.
While Congress has repeatedly passed measures over the last decade to prevent the imposition of these cuts, the short-term fixes – in some cases, for just a few months at a time – and recent tendency of Congress to retroactively fix the cuts have left many physicians concerned and doubtful whether their offices can sustain continued participation in the Medicare program.
Physician offices are just like any other small business. Cuts of this nature can cripple their ability to function. We have heard from many physicians who had to take out loans just to continue to pay their office staff when similar past cuts were temporarily imposed.
With so many administrative expenses in running a practice, physicians cannot take this uncertainty anymore. Physician practices are being squeezed between rising overhead costs, led by the exorbitant cost of medical liability insurance, and decreasing payments from health insurers. Failure to address these cuts may impact all patients.
Obama was re-elected, in part, because of his commitment to preserving traditional Medicare. Yet the cuts that are threatened by the new formula now, and seemingly every year, actually undermine this goal and exacerbate already emerging access to care problems for our seniors.
That’s why efforts to prevent the cuts and replace the flawed formula are supported by AARP.
Congress and the president must work together to prevent a health care access crisis that may very well occur if we fail to prevent these cuts.
Robert Hughes, M.D., is president of the Medical Society of the state of New York.