We knew President Obama hates doctors. Frankly he dislikes anybody who works really hard for his money and becomes successful at it. Unfortunately for the country, he is in a position of power to redistribute income as he sees fit. This is especially bad news for physicians, as his new Medicare funding proposals demonstrate.
In his latest budget plans, he wants to decrease Medicare spending by nearly $400 billion over the next ten years. How does he plan on finding such enormous savings? Hold on to your wallets because this gets really scary.
The president wants to decrease the amount of money Medicare pays to teaching hospitals and the doctors that work and educate there. He will reduce the amount of money Medicare reimburses these teaching hospitals for noncollectable debt, like care for the poor or homeless, which in most tertiary care facilities is a significant percent of the population.
He also proposes keeping physician reimbursements static, with no adjustments for inflation. In other words, physician payments will shrink in real terms from their already low Medicare rates. This is projected to save $100 billion over ten years.
President Obama also want to cut the amount of money Medicare pays towards residency training programs. This idea would save $16 billion over the next decade. Cutting residency training is particularly ironic since Obamacare is supposed to bring in millions more patients into the healthcare system. There are already too few primary care doctors willing to see the Medicare patients we already have. How can reducing the number of physicians being trained help Obamacare succeed if there are not enough doctors to allow patients to be seen in a timely manner?
The list goes on and on. Again it emphasizes income redistribution, taxing more well off seniors with higher copays and paying less to drug companies for medicines given to low income patients. This Medicare plan is like a slow stranglehold on the healthcare system and physicians. The whole enterprise dies a slow death until the only survivors left are low cost providers like nurse practitioners. That's fine if the president thinks it's normal for people to go to the drug store to get their routine check up.
Hopefully Congress will give this plan the respect it deserves and a truly serious reform for the teetering Medicare and Medicaid plans will emerge. In the meantime, we can see how clearly why doctors will never be able to trust the actions of this president. Just keep telling yourself "Two more years. Two more years."