"The AMA and Congress have been playing this game of 'chicken' for more than 8 years," says Dr. Jane Orient, executive director of AAPS. [See: http://www.aapsonline.org/newsoftheday/001097] The AMA threatens doctors will quit seeing Medicare patients unless Congress stops the cuts.
"Meanwhile, the AMA and the government collude on a dictatorial system of price controls."
Unless Congress acts, doctors' Medicare payments will be slashed 23% on Dec 1, then another 6% on Jan 1. The formula automatically kicks in when Medicare spending exceeds a certain amount.
The values for thousands of medical procedures are set by a secretive 29-member panel called the RUC, the Relative Value Scale Update Committee, convened by the AMA. [See Wall Street Journal, Oct 26, 2010.e] Once the RUC determines the formula for divvying up $60 billion for physician fees, the government accepts most of the recommendations and applies a "conversion factor" to give each fee a dollar amount.
Doctors who charge a different amount are heavily fined or sent to prison. Because of the price controls or ban on "balance billing," if the Medicare-allowed fee doesn't cover the cost, doctors simply can't provide the service. Patients who are willing and able to pay are not permitted to make up the difference. It amounts to a form of covert rationing.
"In a free-market system, patients and doctors decide on the fee," states Dr. Orient. "That is not necessarily the same as the insurance reimbursement."
Doctors who opt out of Medicare set their own fees, but patients cannot collect Medicare reimbursement for their services.
Instead of asking for more taxpayer money, AAPS asks Congress to restore the freedom of patients and physicians to make their own decisions, including the amount of the fee. Without all the expensive Medicare hassles, fees are often lower.
SOURCE Association of American Physicians and Surgeons (AAPS)Back to top