A report on the impact of healthcare reform on actual healthcare expenses includes some moderately good news for the overall US budget.
However, it also includes some very bad news for doctors who continue to accept Medicare patients.
But let’s start with the good news. On September 9, 2010, the Centers for Medicare and Medicaid Services (CMS) published National Health Spending Projections: The Estimated Impact Of Reform Through 2019.
According to the CMS study, except for a spike in 2014 when the healthcare exchanges and subsidies come online, healthcare spending is supposed to “to increase 6.7 percent per year, on average—slightly less than the 6.8 percent average annual growth rate projected in February 2010,” for the years 2015 to 2019.
This is projected to occur despite the fact that 32 million people are supposed to join the healthcare rolls in 2014 when those subsidies and exchanges are rolled out.
So how do you keep costs down while extending coverage to 90% of the American people? The CMS report also says that “spending growth is projected to decelerate more substantially” after 2016.
Well, part of those savings are supposed to come from the new excise tax on high-cost health-insurance plans that are slated to start in 2018.
But the rest is supposed to come from physicians who participate in Medicare. According to CMS, the study takes into account the 23.1% reimbursement deductions that are to take effect in December 2010 as well as what will probably continue to be “relatively lower prices paid to providers for services to newly insured Medicaid beneficiaries.”
Patients Who Use Medicare & Medicaid
In other words, if you continue to accept patients who use Medicare and Medicaid, expect to be seeing a lot more patients if you want to earn even the meager amount that you are earning now from Medicare.
This might not be so bad if the two government healthcare agencies actually paid substantial reimbursements. But the truth is that Medicare barely covers the actual cost of treating a patient and Medicaid doesn’t go that far, leaving physicians either having to make up the difference or requiring already poor patients to foot more of the bills for their care.
Healthcare reform is a good idea in the abstract. It is wrong to deny medical coverage to patients with pre-existing conditions and to allow the insurance companies to cut care from a patient who develops a serious illness. And health-insurance costs are definitely a huge burden on employers, including healthcare practices.
But there has to be a better way of achieving the goals of near-universal coverage and cost control than expecting physicians to pick up so much of the tab. Health-insurance companies themselves have contributed hugely to the healthcare crisis. And what are they giving up? Nothing. Instead they’re set to receive millions of government-subsidized customers.
Likewise, the pharmaceutical industry has not been asked to make a single sacrifice, despite the fact that that industry’s advertising budgets and lobbying bills dwarf their R&D budgets, which are frequently subsidized by taxpayers anyway.
The only choice that physicians have today is to do everything in their power to make their voices heard in Congress. The American Medical Association, which supported these punitive reforms, also needs to hear from its members in droves.
In the meantime, physicians—primary care doctors especially—are going to need to start taking a very close look at their earnings figures to see if they’ll even be able to afford to take on the glut of new Medicare and Medicaid patients that are going to be appearing at their doors in the years to come.
Overheard Thoughts