This week Congress is considering the Medicare Access and Children’s Health Insurance Program Reauthorization Act (H.R. 2). Although correct in its ultimate goal, the bill fails significantly as a lasting solution to the problem of how physicians are paid under Medicare. It will make seniors, physicians and taxpayers worse off. As a result, Docs 4 Patient Care–Texas cannot support the legislation.
H.R. 2’s “solution” to the problem is to repeal the Sustainable Growth Rate by adding $500 billion to our nation’s already unsustainable national debt—a debt that is already unprecedented in the history of this nation.
If we are going to care for our seniors by ensuring that physicians are paid adequately for their services, our first consideration must be to ensure that this is not done by placing a huge financial burden on the grandchildren of these patients. Seniors in America would not wish this, if given the facts.
Rather, seniors would wish a conscientious and deliberate solution by our government that ensured their access to healthcare while simultaneously reducing ineffective government spending.
Not only is the bill extremely costly, but it is also flawed in its design. Doctors care deeply for patients and will continue to provide excellent service to them. Yet in order for doctors to be paid fairly for such services, H.R. 2 would require them to comply with burdensome checklists and documentation requirements in order to receive payment.
Without exaggeration, imagine a situation where a physician provides services to a Medicare patient for 45 minutes and then, in order to get paid for that service, the physician has to fill out documentation for another 30 minutes unpaid. This expensive process requires added staff, increasing overhead. It is a not a tenable solution for doctors or Medicare beneficiaries.
More time spent on filling out paperwork means fewer patients can be seen, which means that the costs of providing these services increases.
The issue becomes more acute as Medicare beneficiaries are expected to grow by 20 percent within the next 10 years. We will now be asking doctors in this country who provide Medicare services to undergo expensive and unrealistic documentation requirements in order to be paid. The only result will be a departure by physicians providing services to these needy patients.
Any solution must make it simple and easy for physicians to submit their Medicare claims. Otherwise Medicare patients will suffer, through fewer providers of these services. More time spent on filling out paperwork means fewer patients can be seen, which means that the costs of providing these services increases.
These additional requirements would further remove doctors from the independent practice of medicine and, if they stay in the profession, the increasing likelihood of them becoming employed by larger healthcare corporations. This further centralizes the practice of medicine by usurping the doctor-patient relationship. Once employed, doctors are answerable to their employer, and no longer to the patient. Unless rectified this will be the future state of the American healthcare system.
H.R. 2, although admirably trying to solve the long-term problems of adequate Medicare payment to physicians, falls very short of this supposed intent. At the very least, Congress needs to pay for the $400 billion cost upfront by reducing unnecessary government services and enacting cost saving reforms, in order to avoid further increasing our national debt, which the next generation will ultimately have to bear. Furthermore, Congress ought to simplify the processes by which physicians can file Medicare claims without excessive bureaucracy that neither our physicians or our healthcare systems can afford, in order to establish long-term sustainability of care to Medicare patients.
