Doctor Shortage, The Medicare Meat Ax

Medicare is not subtle when it comes to paying doctors. Medicare swings a meat ax rather than carving with a scalpel.

Medicare actions have a profound effect, not the least of which is that private plans obsequiously follow the Medicare lead in reimbursing doctors.

Medicare has almostsinglehandedly created a primary care shortage by underpaying primary care doctors by 300 percent compared to specialists. Only one of 50 medical graduates now enters primary care because of low payments.

Now Medicare has decided to chop the head off specialty fees by up to 40% for many cardiology procedures by 45% of imaging services. The idea? If specialists are paid less, the Medicare budget will go down along with demand for services.

Never mind that the public knows imaging is a superb technology. Never mind cardiologists have helped drop death rates from heart attacks by 50% over the last decade. Never mind patients (and lawyers) think of imaging and cardiology procedures as the standards of care. Never mind that specialists’ practice expenses are outstripping inflation.

Medicare experts, operating at a distance from practices and with little knowledge of what transpires on the ground, have decided to arbitrarily and capriciously dictate what doctors are paid.

Now for the latest news about Medicare specialty cuts for cardiologists and radiologists. Both specialty groups have protested the aforementioned cuts which may be superimposed on a 21.2% Medicare cut scheduled for March 1. Both have said these cuts will cut access and drive many outpatients based specialty groups out of business, in effect, driving patients into the arms of higher priced hospital facilities, where facility fees and regulations will drive up costs even more.

The American College of Cardiologists filed a lawsuit against the cuts. But a U.S. District Court in Florida ruled against the Cardiologists, saying it, the Court, had no authority to countermand Medicare.

Jack Lewis, the CEO of the College, responded, the decision “sets the precedent that CMS has complete and unchecked control over physician reimbursement for patient care even where its determinations are based on faulty data. “

In support of the cardiologists, the Americab College of Radiology, commented, “Here there was no give-and-take a far as sharing data and inn transparency of the information from the proposed rule to the final rule.”

Oh, well, when you’re Medicare, and you have unfettered access to a meat ax, your instinct is to swing it and severe the head of the cost monster, no matter what the consequences to the body below.