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What are Doctors Worried About?

Lower Reimbursements, Doctors Pushed Out by Costs, Burden of Bureaucracy, Lack of Tort Reform

Congress’ Medicare Two-Step

In the current House bill, the impending 21% cut to physician’s Medicare reimbursements remains in effect for January 2010. The reason is that the “savings” claimed under current proposed health care legislation depends on these deep cuts to Medicare spending. This is how it becomes “budget neutral.”

Here’s the hitch—Congress has putting off these cuts since 2002, because they’re very unpopular with doctors and seniors.

For this reason, many believe that these cuts will ultimately not occur—they will simply be handled in a separate bill.

Congress has found itself with two unpalatable options; either add an additional $247 billion to the cost of health reform by doing away with the coming Medicare cuts, or keep the cuts in place and puts doctors and patients in a precarious situation.

Billions in Cuts to Medicare Reimbursements

“[The bill] would leave in place the 21 percent reduction in the payment rates for physicians currently scheduled for 2010. At the same time, the bill includes a number of provisions that would constrain payment rates for other providers of Medicare services.”
—Congressional Budget Office, Analysis of H.R. 3962, October 29, 2009

Doctors Pushed Out by Costs

“Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.”
—Julie Connolly, “Doctors are Opting Out of Medicine,” The New York Times, April 1, 2009

Burden of Bureaucracy

“Increasing government oversight will not only hurt doctors in the pocketbook, as reimbursements are inevitably cut. It will also lead to greater bureaucratic inefficiencies. There will be more paperwork, less approvals and less time for cures.”
—Marc Seigel, M.D., “Why Doctors Are Worried,” Forbes.com, October 22, 2009

In a recent forum, Dr. David Fields said that the problem with government-imposed treatment guidelines is that they “tend to forbid better-than-average medical care; guidelines are always average medical care. […] They tend to cramp the physician who can do better than average.”
—Dr. David Fields, “Doctors on Health-Care Reform,” Wall Street Journal, November 6, 2009.

A Lower Quality of Care

“Legislators brush off the issues of patient safety and quality of care as some propose the dramatic expansion of scope of practice of non-physician providers as a way of providing cheaper health care. Yet, none of the proposals seriously take on the issue of the billions of dollars wasted on medical liability crisis that strangles medicine. States are cutting Medicaid reimbursements and the federal government wants to cut Medicare reimbursements. These actions will dramatically affect patient care and access of patients to physicians.”
—Peter E. Lavine, M.D., President of Medical Society of the District of Columbia, Jan/Feb 2009

Lack of Tort Reform

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