(Mike Chamberlain/Cranky Hermit) – Scheduled cuts in physician reimbursements by Medicare are forcing an unprecedented number of doctors to drop out of the program that provides medical care for seniors. This could leave thousands of elderly in Nevada and millions nationwide without access to a doctor.
Delen Goldberg tells the story in the Sun but leaves out a very important piece of it,
Inaction in Washington is causing Nevada doctors to turn away Medicare patients.
Congressional leaders have failed to set reimbursement rates for doctors who treat patients covered by the federal insurance system, so rather than face uncertainty over payments, some doctors are closing their practices to Medicare recipients.
As a result, elderly and disabled patients across the state — particularly in rural and Northern Nevada — are facing increasing difficulty finding doctors willing to treat them.
Goldberg discusses attempts by Congress to change the system.
The House tried to reform the formula last year but the measure died in the Senate because of its high cost. Senate Majority Leader Harry Reid also tried to legislate a fix but couldn’t muster enough votes.
What she doesn’t mention is that this “doc fix” could have been enacted earlier but for a cynical maneuver by Senator Reid and other supporters of ObamaCare designed to preserve the illusion that the legislation would reduce the deficit.
One may wonder why wouldn’t the comprehensive health care legislation – that touched on such subjects unrelated to health care as tanning beds, student loans, and cellulosic ethanol – have addressed this issue that is so fundamental to Medicare? The fact is ObamaCare does address the scheduled cuts in Medicare reimbursements – by explicitly keeping them in place.
The bill that was originally introduced in the Senate pared the reductions from 21% to 0.5% for 2010 but restored the scheduled cuts for subsequent years.* On the eve of the Senate vote just before Christmas recess last year, Senator Reid attached a managers amendment to the bill that, among other things, preserved the scheduled cuts in reimbursements for all years.**
This was done because enacting the “doc fix” would have destroyed the myth that ObamaCare would reduce the deficit. Supporters of ObamaCare constantly touted the CBO report that claimed the legislation would reduce the deficit by $132 billion in its first decade. A separate CBO report estimated the “doc fix” would add $210 billion to the deficit in that same time, completely wiping out the alleged savings from ObamaCare – and then some.
So the plan was to pass ObamaCare with the scheduled payment reductions in place, then reverse the cuts in separate legislation – incurring the costs but in such a way that ObamaCare supporters could still point to a CBO score showing the bill would reduce the deficit. Senator Reid even admitted that, with respect to Medicare payments, “the doctors…know we’re going to do something to take care of them.”
So when Harry Reid stated on the campaign trail that ObamaCare would reduce the deficit, he did so knowing that it was only possible by slashing payments to doctors who treated Medicare patients. And when Barack Obama asserted that under ObamaCare you could keep your doctor if you wanted, he did so knowing these cuts were part of the law – cuts that would force thousands of physicians to refuse their Medicare patients.
It is not “inaction” that is responsible for the scheduled reductions in reimbursements that are forcing doctors to leave Medicare, but deliberate and cynical action by the advocates of ObamaCare. While they can lament and condemn the cuts and their consequences, every Senator and Congressperson who voted for ObamaCare voted for these cuts. And every politician and pundit who demonized ObamaCare opponents for trying to highlight unintended consequences such as this shares responsibility for them.