The worst fears about Obamacare are now being realized in a decision on Monday by the Medicare Payment Advisory Commission (MPAC) established by the law to supervise $500 billion in Medicare cuts. MPAC, whose decisions have the force of law, has voted to impose drastic pay cuts on all doctors under Medicare and, by extension, under Medicaid (which tends to follow suit). The cuts will effectively reduce the real pay for specialists by 50% over the next ten years --- including a 25% reduction over the next three years -- and cut general practitioners' pay by one-third over ten years (and that assumes that inflation stays down at 3% a year).
MPAC has ruled that specialists must accept a 6% cut in their fees per year for each of the next three years followed by a seven year freeze in their fees without any adjustment for inflation. If inflation stays very low -- at 3% per year -- this cut amounts to an 18% cut in nominal pay and a 50% cut in real pay for specialists. General practitioners will face a ten year freeze on their pay, reducing their real compensation by one-third assuming ongoing low inflation. Higher inflation, of course, would make the cuts in real pay even more drastic.
The consequences of the MPAC decision will be immediate and drastic:
* Many physicians, and many more specialists, will refuse to treat Medicare patients. It will become very, very difficult to see a cardiologist or an oncologist or a gastroenterologist or OB-GYN specialist if you are on Medicare unless you are willing to pay out of pocket or have the kind of health insurance coverage from a private source that would reimburse for their care.
* More and more medical care will be turned over to nurses or physician assistants, and fewer people will ever get to see a doctor on Medicare.
* Private health insurers will follow in the footsteps of the Medicare program and likely slash their fees as well.
* Fewer students will enter medicine, and a major shortage of doctors will reduce the quality of medical care in America drastically.
The MPAC cuts will bring American doctors' incomes more into line with European doctors who typically earn half or less of what their American counterparts earn -- and deliver worse medical care as a result.
We have got to stop these MPAC cuts from taking effect. The very future of Medicare and of our entire health care system is at stake. 'If they are allowed to stand, Medicare will become akin to Medicaid or public housing -- a program for poor people' who cannot afford to pay for medical care from specialists outside the system.
(and that is it in a nutshell. I went from a retired small business guy with Medicare insurance to a poor man doomed to seek medical care in a mass of screaming crack babies, drug addicts, drunks and the insane. BEGGING for an appointment. Thanks Obama, you sorry bastard.