Stopping The Hemorrhage Of The SGR Pay Cut Is Not Enough

Our guest blogger is Mandy Krauthamer Cohen, executive director of Doctors for America.

On Thursday night, the House voted to reverse the 21% pay cut to physicians that went into effect on June 1st. While physicians everywhere appreciate the fact that the House stopped the hemorrhage of the SGR pay cut by voting for the Senate version of the “doc fix”, the fact that it is only a 6 month temporary solution is extremely distressing. What started out as a three and a half year “fix” when it was first introduced in May – with allowances for primary care to grow at higher rate – was whittled away over the past month to a six month temporary fix that expires on December 1st.

When are we going to stop kicking the can down the road and permanently fix the SGR – or at least lay the foundation to make a permanent fix fiscally feasible? The House was able to muster the support for a permanent “doc fix” back in 2009 – though that support has likely vanished as the election draws closer and any mention of the word deficit sends everyone into a tailspin. The Senate voted down a permanent fix for the SGR last year –clearly this is an uphill battle.

While Washington continues to play politics – it is the seniors, military families and physicians who care for them that are caught in the middle. The baby boomers begin entering Medicare in six months, and these new Medicare patients may have difficulty finding a doctor as it is. According to the AMA, about one in four Medicare patients looking for a new primary care physician are having trouble finding one. About one in five physicians are already limiting the number of Medicare patients they treat because of the instability and uncertainty of Medicare payment.

The constant uncertainty about Medicare payment is not only difficult for physicians financially – particularly internists, family physicians and geriatricians — but it also engenders cynicism of government among physicians. Given, that the new reform legislation will greatly increase demand for physicians’ services through expansion of insurance coverage, it doesn’t seem like the best time to be provoking skepticism among physicians.

I was pleased to watch President Obama’s weekly address on June 12th where he discussed the need for a permanent fix for the SGR. He backed that up with his statement last night after the House vote:

OBAMA: I believe we need to permanently reform the Medicare formula in a way that attacks our fiscal problems without punishing our hard-working doctors or endangering the benefits on which so many of our seniors rely. I look forward to working with Congress to achieve that goal, and I’m gratified that in the meantime they’ve taken the provisional step of blocking this pay cut.

Good stuff – but it’s time to turn those supportive statements into action. We can’t wait until Thanksgiving before we continue the dialogue on how to move to a more permanent payment solution — this issue is too complex, expensive and laden with pitfalls. It’s time to get to work.