In Forbes this week, Sally Pipes of the Pacific Research Institute asks and answers a key question about Medicare’s future: Is any “doc fix” sufficient to secure Medicare’s future? “Doc Fix” is shorthand for addressing a complicated Medicare reimbursement issue (latest CRS report) which threatens doctors’ ability and willingness to remain Medicare providers and thereby to preserve access for beneficiaries. Congress has addressed the issue numerous times in the past and will again take up the question when it reconvenes later this month. It is worth noting the President’s government takeover of healthcare law could have but failed to address the “doc fix” reimbursement issue in any meaningful way.
Pipes makes two critical points in the Forbes piece. First, previous “doc fixes” to avert reimbursement crises have not stopped doctors from limiting access for existing Medicare patients or refusing to accept new Medicare patients. Nor has it stopped some doctors from leaving the Medicare program altogether. Pipes writes:
Despite the constant deferment of pay cuts, many physicians still find it challenging to see people covered by Medicare. They receive substantially less from the government to treat Medicare patients — just 81 percent of the private insurance rate.
As a result, some physicians have abandoned the program altogether. A 2010 Houston Chronicle report revealed that more than 300 doctors in Texas stopped participating in Medicare between 2008 and 2010.
The American Medical Association states that nearly a third of primary care docs limit the number of Medicare patients they’ll see. And the American Academy of Family Physicians (AAFP) reports that the number of doctors refusing to take part in Medicare has doubled since 2004.
Absent a doc fix, many more physicians would surely join them on the sidelines. A 2010 AAFP survey noted that six in ten physicians would stop accepting new patients if reimbursements were cut.
For the nearly 50 million Americans who receive health benefits through Medicare, an exodus of physicians from the program would be devastating.
Second, Pipes observes that the “doc fix” reimbursement issue, however successfully addressed at any given time, misses a larger point: Medicare is facing imminent bankruptcy absent fundamental reform. Pipes writes:
Without reform, Medicare’s hospital insurance trust fund will be exhausted by 2024. According to a 2011 report from the Medicare Trustees, the program’s long-term unfunded liabilities amount to $36 trillion.
The Trustees caution that this figure could be much worse: “The actual future costs for Medicare are likely to exceed those shown by the current-law projections in this report.”
Obamacare purports to take on these financial challenges. But its proposed remedies will fail.
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The doc-fix ordeal exemplifies what’s wrong with our Medicare system. Injections of cash in the short term won’t preserve seniors’ access to care in the long term — and will instead hasten the program’s bankruptcy.
Nothing less than fundamental reform is needed.
The President’s government takeover of healthcare law essentially ignored the “doc fix” reimbursement issue and, in fact, hastens Medicare’s bankruptcy; possibly as early as 2020. While continuing to address the “doc fix” issue is necessary to preserve Medicare access for beneficiaries in the near term, no one should be under the impression that any “doc fix” will change Medicare’s fiscal trajectory absent comprehensive changes to strengthen and secure the program.