Doctors Got Screwed By Congress And The AMA Rejoices

Doctors' livelihoods were seriously damaged by the SGR fix that was recently passed by Congress. How can that be? The American Medical Association has been trumpeting its involvement in finally repealing the dreaded Sustainable Growth Rate legislation that has threatened the incomes of physicians every year for nearly two decades. How can removing this cloud over medicine be a bad thing?

No matter what the numbers say in the bill, the final outcome is that doctors will continue to lose money taking care of Medicare patients. And this loss continues at a steadily increasing rate over time. The Medicare Access and CHiP Reauthorization Act (MACRA) gives physicians a 0.5% raise every year for five years followed by a freeze for the next five. Seriously? We're supposed to be happy we've been given extra handouts worth a total of 2.5% over five years and nothing after that? That's barely more than what one year of medical inflation is currently running, which is about 2.46% in the last twelve months. At the end of ten years, physician incomes will be severely diminished by the ravages of inflation.

By comparison, the Los Angeles teachers union recently won approval of a 10% salary increase over the next two years. And if you count the back pay the teachers lost during the recession and that the union managed to claw back during negotiations, they are looking at nearly a 15% salary increase over the next 14 months. If doctors got a 15% raise in Medicare reimbursements, there would be parties at every medical office and Mercedes dealer across the country.

Let's not forget the poor primary care physicians who got seriously bait and switched by Obamacare. As part of the ACA's attempt to lure more PCP's into accepting Medicaid patients, they were granted a two year time period where Medicaid reimbursement was increased to the same as Medicare. Now that thousands of new Medicaid patients have found doctors, the government has taken that money away. MACRA sends PCP's down the river by not returning reimbursements back to the already abysmal Medicare levels, saddling thousands of doctors with Medicaid patients.

This new law also is not fully funded and will cost the government over $100 billion over the next decade. It will pass that debt down to our children and grandchildren and their grandchildren. If Congress wanted to sweep the cost of fixing the SGR under the rug so expeditiously, it could easily have done the same thing last year, or even ten years ago when it would have been much cheaper. Now that it's completed, I suppose an extra $100 billion added to the government's $18 TRILLION debt isn't such a big deal.

It's no wonder that barely one fourth of all doctors in the country have joined the AMA. Who would want to join an organization that thinks maintaining the status quo is a victory for doctors? The group needs to get their executive directors out of corporate headquarters and start practicing real medicine before all they are left with as members are medical residents and retirees.