I'm so tired of talking about the doc fix

I can’t believe how many email I get about this.

Look, there’s a problem with Medicare funding.  I’ve already talked about this:

Basically, back in the 90’s, Congress tried to slow the rising costs of Medicare by pegging how much they pay doctors to a formula.  Yes, the formula underestimated how quickly medical costs would rise, such that every year, Congress “fixes” the problem by ignoring it and pushing it to next year.  They’ve been doing it so long that if they let the SGR kick in, reimbursement rates to physicians would drop overnight by more than 20%.

That’s me.  Quoting myself.  That’s how bad it’s gotten.

They let the SGR kick in.  Reimbursement rates dropped a ton.  The usual stories appeared about the sky falling.  Docs will rush to leave Medicare.  The system will collapse.  This is why the ACA sucks.  Blah blah blah.

Look.  First of all, the ACA has nothing to do with the SGR.  Actually, it has little to do with Medicare.  Not one more person got Medicare because of the ACA.  So if you think Medicare reimbursement rates are too low, so be it.  It has nothing to do with health care reform.

Further, this is all theater.  There’s no way they will let the SGR kick in permanently.  This is politics.  They will increase the rates.  They always do.  They always will. The politicians don’t have the stomach to actually lower costs.  So everyone can chill.  They will do what you want and spend, spend, spend.  They will even pass it so that docs who were reimbursed at rates lower than they expected can get the money back later.  Sure, it will cost more to file that extra paperwork.  But that’s what you want, right?  More spending!

I’m exasperated because it seems to be the same crowd screaming about the deficit and high spending that’s screaming about the lower reimbursement rates.  You can have lower spending or you can have lower deficits, but you can’t have both.  Pick.  Stop wasting my time.

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