Dying For Insurance: The Politics of Rationing

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The Politics of Rationing

If you wonder if your Representative is voting with your best interests in mind, the answer is maybe not. The recent passage in the House of Representatives of the repeal of the Medicare physician payment formula is a good thing. If you are unfamiliar with doctor's reimbursement under the formula, simplistically if will reduce doctor's payments by 21% next year. The decreases in payments have been voted down every year until today. The Senate has already voted against the repeal which means that unless there is an agreement, the cuts in payments to doctors will be reduced.
The votes against the cuts were almost entirely upon party lines with 1 Republican voting for and most Democrats voting against the cuts. Many of the reasons for voting were not altogether altruistic or for the right reasons. Many Democrats voted to maintain doctor's payments so that the cost would not show as a deficit if the Healthcare bill is passed and gain political points. Many Republicans voted against the repeal because they wanted any potential Healthcare bill would to show a deficit and gain political points. The outcome is the right one, but for the wrong reasons. Doctors are already planning to eliminate Medicare patients. According to Jack M. Bert, MD, " the sustainable growth rate (SGR)formula is flawed and that future cuts may have physicians looking for a Medicare-exit strategy. Eighty percent of the physicians in my 37-man group have decided to electively cease seeing Medicare patients if the 21%reduction goes into effect,” he told Orthopedics Today. The intent may not be obvious, but rationing is coming.

Doctors are already being paid less than their cost for many services or not paid at all for others. The country does have limits on what to spend without going deeper in debt, so we cannot continue the current programs without some increase to some people on Medicare. But that vote would cause many politicians to lose office. So without changes, doctors will either retire or stop accepting Medicare patients since they will be unable to remain profitable as the population ages. If the Senate does not rescind the 21% decrease in payments to doctors, 2010 will be the year that the availability of doctors to Medicare patients starts dropping dramatically. If that does not create rationing of services, someone will need to explain it to me. AARP is not getting the message from the amount of people that have dropped membership. The answer is for those in Washington to start voting for our interests rather than vote to preserve their political skins. But, don't hold your breath.

TVP tvp@dyingforinsurance.com