Sarasota Health News

Editor's notebook, March 8

David Gulliver - posted 3:30 p.m. Monday, March 8

In the “Animal House" that is Medicare reimbursement to doctors, we’re now into “double-secret probation.”

That’s the status Dean Wormer applied to the Delta House bunch in the classic movie. And that’s what Congress has done to doctors by once again failing to resolve the problem.

Little has changed since I wrote about this issue in 2007 while at the Sarasota Herald-Tribune. I’ve updated it in our story to the left, but in short: Federal law calls for annual cuts in what Medicare pays doctors. Doctors protest, Congress caves, and kicks the can down the road for a year. But each time the annual cuts stack up -- now totalling a 21.2 percent reduction.

In Sarasota County, where almost 30 percent of residents are of Medicare age, this is a big deal. It can mean a deep cut in what some practices receive from two-thirds of their patients.

Back on Feb. 26 -- the day that Sen. Jim Bunning, a Hall of Fame baseball pitcher, threw a curve and seemed to kill a solution -- I was talking with a group of nine local doctors. All but one said the cuts would force them to tap lines of credit or take out loans.

By the following Wednesday, Bunning had caved, and Congress kicked the can one more time, just a month down the road this time. On April 1, the cuts again are scheduled to take effect.

At the risk of annoying the physician on my board of directors (and a lot of my readers) I’ll say that health care reform almost has to involve a pay cut to physicians. It’s hard to look at the finances (as we did in our primer, see the archived story) and see any other solution.

But the current method is deeply flawed, both in its technical design and in any sort of real-world test. Applying arbitrarily sized and timed cuts regardless of practice size, type or demographics can demolish an otherwise sound business plan and force layoffs or bankruptcy.

But instead of coming up with a real solution, the Medicare-cuts game plays year after year, and every time, Congress punts instead of pushing for a solution.

Fixing this problem is such a big deal that the American Medical Association has signed onto the current healthcare reform plan, even though it ignore most of doctors’ other major causes.

Now the region’s doctors are taking the most visible stand I can remember on the issue. The Sarasota and Manatee county medical societies are holding a rally and media event on Wednesday, March 10. No doubt other rallies are going on across the country.

Will it be enough to make Congress definitively act, or will the lawmakers once again punt? We'll know soon -- by April Fool’s Day, appropriately enough.

---

(This column was adapted from the editor's email message to subscribers from March 3.)





	Editor's notebook, March 8 David Gulliver - posted 3:30 p.m. Monday, March 8 In the “Animal House" that is Medicare reimbursement to doctors, we’re now into “double-secret probation.” That’s the status Dean Wormer applied to the Delta House bunch in the classic movie. And that’s what Congress has done to doctors by once again failing to resolve the problem. Little has changed since I wrote about this issue in 2007 while at the Sarasota Herald-Tribune. I’ve updated it in our story to the left, but in short: Federal law calls for annual cuts in what Medicare pays doctors. Doctors protest, Congress caves, and kicks the can down the road for a year. But each time the annual cuts stack up -- now totalling a 21.2 percent reduction. In Sarasota County, where almost 30 percent of residents are of Medicare age, this is a big deal. It can mean a deep cut in what some practices receive from two-thirds of their patients. Back on Feb. 26 -- the day that Sen. Jim Bunning, a Hall of Fame baseball pitcher, threw a curve and seemed to kill a solution -- I was talking with a group of nine local doctors. All but one said the cuts would force them to tap lines of credit or take out loans. By the following Wednesday, Bunning had caved, and Congress kicked the can one more time, just a month down the road this time. On April 1, the cuts again are scheduled to take effect. At the risk of annoying the physician on my board of directors (and a lot of my readers) I’ll say that health care reform almost has to involve a pay cut to physicians. It’s hard to look at the finances (as we did in our primer, see the archived story) and see any other solution. But the current method is deeply flawed, both in its technical design and in any sort of real-world test. Applying arbitrarily sized and timed cuts regardless of practice size, type or demographics can demolish an otherwise sound business plan and force layoffs or bankruptcy. But instead of coming up with a real solution, the Medicare-cuts game plays year after year, and every time, Congress punts instead of pushing for a solution. Fixing this problem is such a big deal that the American Medical Association has signed onto the current healthcare reform plan, even though it ignore most of doctors’ other major causes. Now the region’s doctors are taking the most visible stand I can remember on the issue. The Sarasota and Manatee county medical societies are holding a rally and media event on Wednesday, March 10. No doubt other rallies are going on across the country. Will it be enough to make Congress definitively act, or will the lawmakers once again punt? We'll know soon -- by April Fool’s Day, appropriately enough. --- (This column was adapted from the editor's email message to subscribers from March 3.)