Blaming congressional inaction, the nation's largest doctors' lobby is urging lawmakers this month to block a steep cut scheduled to hit Medicare doctors at the start of December.
The American Medical Association (AMA) is warning that a failure to prevent the cut would be "a catastrophe for seniors" because many doctors would stop seeing Medicare patients altogether. Physicians are facing a 23 percent cut on Dec. 1, and an additional 1.9 percent cut is scheduled for Jan. 1.
"This is not about doctors," AMA President Cecil Wilson told reporters on a press call Monday. "It's about access to care for senior citizens."
Wilson minced no words about where the blame for the cuts should rest. "It's not AMA that's not fixing the problem. This is a congressional problem."
Lawmakers, he added, "are putting the lives and health of seniors at risk."
AMA is endorsing a temporary pay patch, delaying the cuts for 13 months and providing a 1 percent pay increase for doctors instead. The time cushion will allow Congress next year to consider ways to scrap the 13-year-old formula — the Sustainable Growth Rate (SGR) — that dictates Medicare physician payments, replacing it with a system that better reflects the true cost of delivering care, AMA says.
It's hardly a new argument.
The SGR was designed to prevent Medicare doctor payments from bankrupting the program by indexing reimbursements to the growth of the economy. Because healthcare inflation has risen much faster than GDP in recent years, the SGR has called for physician cuts every year since 2002. Congress, however, has usually stepped in with temporary patches to prevent those cuts.
Years of kicking the can down the road, though, has caused the cuts to compound, leading to next month's scheduled 23 percent reduction.
Fixing the problem — even patching it — doesn't come cheap. The cost to delay the cut by 13 months is estimated at $15 billion. A permanent fix would run well above $200 billion — so expensive that Democrats never even tried to include it as part of the new healthcare reform law.
Lawmakers on both sides of the aisle agree the SGR is flawed and needs reforming, but cost concerns have always prevented a permanent fix — a hurdle that only got higher after Tuesday's elections, which were largely a referendum on deficit spending.
To prod lawmakers to action, AMA is taking out a full-page ad in USA Today this week, with others to follow next week in various Capitol Hill papers.