Strength in Numbers

As I am sure many of you have heard, the Center for Medicare and Medicaid Services (CMS) is once again set to cut reimbursement to physicians.  In fact, that cut is supposed to take effect today.  This is not the first time physicians have faced this cut, but Congress in the past has passed legislation to delay cuts.  This may still occur.  In fact, CMS will not process claims for physician reimbursement during the first two weeks of March, as a temporary patch is once again expected.

Whitecoat makes an interesting suggestion on his blog:  that physicians should just allow the cuts to take effect, but then stop taking care of Medicare patients.  His argument is simply that instead of allowing our healthcare system to continue to teeter on brink of death, why not just allow the natural history of the disease to progress and force the collapse of our healthcare system that will in turn, push us more towards the overhaul that we so desperatly need.

One group of physicians at the Mayo Clinic in Arizona has done just that.  That have stopped seeing Medicare patients.  There are, of course, two sides to this argument.  First, and foremost, how would such an approach in large numbers affect care for those who qualify for Medicare?  Second, is it fair for physicians to accept a 21% pay cut in return for taking care of often very complex medical problems?  Let's not forget that the current level of reimbursement is hardly adequate.

I have another suggestion, and it's a crazy one.  What would happen if all of the physicians in a certain specialty in a certain area decided to form what would in essence be one large practice?  What if all of the orthopaedic surgeons in one state decided that they were going to join together and refuse to take care of Medicare patients? 

We're going to get to a point where crazy things have to happen.  We've seen what Congress has been able to do with health care reform.  For the send time in 20 years, they have attempted to make a change, and their attempt failed.  The jury is still out on what can be done, as President Obama is pushing hard for meaningful reform to occur.  I've said it before, and I'll say it again, we're asking the wrong people to enact the change. 

It's time for physicians to take charge of their own destiny.  While many of us would rather not get in the mix and just stick to the business of taking care of our patients, this approach is nearly as ineffective as my crazy idea above.  We're not doing our patients any favors by allowing this current strategy of using temporary patches to stave off the inevitable.