Heartfelt with Dr Melissa Walton-ShirleyView all posts »
Congress? You again? Why my 2%?Mar 1, 2013 15:30 EST
Medscape reports G-R-E-A-T news today (not!): "Barring some last-minute rescue. . . . Medicare reimbursement for physicians and other healthcare providers will decrease by 2%. The scheduled 2% reduction in Medicare reimbursement to physicians and other providers presumably would apply to all services rendered, beginning March 1. The Centers for Medicare & Medicaid Services had no comment as yet on how the pay cut would be implemented. Judging by what occurred in previous planned pay cuts, it is likely the effects will not be felt for 14 days while Medicare administrative contractors temporarily sit on electronic claims."
So, let's see
On top of the two weeks of nonpayment while the government tries to figure out how they are going to implement the next rounds of cuts, I can add that 25% reimbursement decrease for any test performed above and beyond the first test of the day and subtract the approximate 300% increase in health insurance for our employees over the past decade and the increase in equipment costs, federal taxes, and the lack of payment on behalf of Medicaid. In addition, I get to look forward to the latest smoke screen produced by Anthem, which doesn't want to approve the stress exam on a 59.8-year-old female—who has been postmenopausal since she was 27—because she's not yet 60.
In other words: if you ever thought a doctor must really love to practice medicine in order to get through years of low pay, rigorous training, and time away from our young families, there has been no greater example of the need for that love for medicine that must sustain us now.
Meanwhile, back at the ranch (the Kentucky ranch, that is)
Our legislators are shaking in their boots this week about the possibility of making our state smoke-free to save millions. They (who still believe the world is flat) have pushed House Bill 190 into the judiciary committee so they can reinvent the property-rights wheel regarding smoke-free venues. And we can't get our president to utter the words, "smoke-free America" for love or money while our nation spends $203 billion per year on illnesses from first- and secondhand smoke exposure.
And the waste doesn't end there. According to CBS news, Congress "added another $70 billion worth" of pork on January 1 to our already broken budget, which included a "tax write-off for Hollywood—a $20 million break anytime a TV show or movie is shot in an economically depressed area of the United States, a subsidy for rum made in Puerto Rico, and a tax credit for every kilowatt of electricity produced by wind." According to the Citizens Against Government Waste (CAGW), "The latest installment of CAGW's 21-year exposé of pork-barrel spending includes $255 million to upgrade the M1 Abrams tank, which is opposed by the Pentagon; $5 870 000 for the East-West Center, . . . $3 388 000 for national fish-hatchery system operations, and $3 000 000 for aquatic-plant control."
Yes, by all means, take the 2% of my salary that has already been sliced and diced x 100 and fund all of these lifesaving projects with it.
The balance of all these revelations
The 2% reduction in Medicare-reimbursement is completely unnecessary and an embarrassing substitution for the opportunities we should grasp to balance the medical budget instead. Furthermore, our Congressional representatives have set us on the course of an approximate 15- to 20-year cycle that sent private-practice America scurrying ‘neath the temporary umbrellas offered by healthcare systems for a season until the reup.
Some will be regurgitated back out onto the streets to rebuild buildings, rehire staff, and repurchase equipment.
Others will hang on for retirement, and the newbies will never be able to go it alone. In other words, the harm is irreparable to American medicine.
Although I have never argued against the notion that we certainly need overhaul and improvements, I am against trends that cause patients to suffer. They are now served by systems that proudly boast new hospitalists programs whose only real aim is to improve the bottom line while wrecking interphysician communication and patient confidence. We continue to prescribe medications patients cannot afford. We deny access to outpatient care while we proudly boast that we deliver care to anyone needing hospital admission or an emergency-room visit, when in fact if we embraced outpatient care needs, we would reduce the number of emergency-room visits and in-patient admissions. We are in shambles, and it's a shame because it's "helpable."
Where to now?
I suggest someone—anyone!—try to get the ear of our legislators to explain what real healthcare reform means. It's not budget shifting. It is risk shifting. It is efficacy shifting. It is prevention. It's education. It's efficiency. It is tort reform. It's smoke-free. It's prosecution of graft and greed.
This is not what we are becoming, and it's not what we are now. American medicine is currently nothing that medicine should be. But the real shame in all of this is that we could be great again. Now that truly would be fantastic and even the G-R-E-A-T-E-S-T of news.