How can I make this less painful? I
think the best way is to just say it. The Centers for Medicare and
Medicaid Services (CMS) is in the process of telling patients to bend
over and prepare to be screwed. I don't mean just literally, but
factually as well.
If you wonder why doctors will be
cutting Medicare patients and moving many out the door, just read this blog by Dr. Jordan Grumet. Then read the press coverage of what
the CMS has planned for 2014. The CMS intends to pay flat rates for
Medicare visits to outpatient clinics instead of payments that vary
with the severity of the patient's condition.
That's right, with the CMS proposed
change, a healthy sixty five year old with a cold will lead to
physician charges that are the same for a ninety five year old with
congestive heart failure, emphysema, and out of control diabetes.
What does this mean? Physicians, fatigued and overwhelmed with
patient care, will be much more likely to avoid sickly seniors. It
pays the same, why not select for the most healthy of the Medicare
population? Yes, doctors will be forced into this and seniors with
many comorbid conditions will be forced to use emergency rooms
instead of seeing their doctor.
What upsets me even more is this is
what CMS is doing to doctors, this parallels what the Affordable Care
Act is doing to many doctors, and this will likely force many doctors
out of the practice of medicine, as we know it today. This will
cause many doctors to open contract medicine offices and not serve
Medicare and Medicaid patients. Contract medicine encompasses
“boutique”, “concierge”, “retainer”, and “direct care.”
For the present, hospital emergency
rooms have been left untouched, but when CMS moves into this area,
look out Medicare patients. Patients that have multiple medical
conditions may be facing euthanasia because no doctor will be able to
afford to treat people with multiple medical conditions.
This is serious enough that writing
your members of Congress should be your goal in the month of
December. It would not hurt to write letters to the editor of your
local newspaper.
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