It's Officially Over. My Goodbye to Medicine is Imminent.

This is what I've been talking about. Forced physician participation, in a program with draconian cuts in our reimbursement, by a committee that is shielded from our ability to petition it for a redress of grievances.

Who the hell do they think they are? Seriously. How unbelievably and excruciatingly arrogant of them to tell doctors whom they have to enter into doctor-patient relationships with, and to limit reimbursement by fiat without any chance of negotiation. By what right?

The text below. Even though I've expected it, the blow isn't softened. To paraphrase Kipling, I "see the things I gave my life to, broken". I will have to go Galt now. I haven't any choice.

June 5, 2009

Concerns Grow as HSR Details Emerge

The latest information from Washington indicates that the U.S. Senate Health, Education, Labor and Pensions Committee will introduce their proposal for health system reform (HSR) by the middle of this month. A separate bill from the Senate Finance Committee is also in the works.

Indications are the two separate aforementioned Senate bills will differ a great deal on a number of HSR issues, including the public plan element insisted upon by President Obama. The two bills will probably be combined into one piece of legislation and ready for Senate consideration in July. In addition, House Speaker Nancy Pelosi has committed to passing the House HSR bill by July 31.

Clearly, Congress and President Obama have an ambitious timetable for passing sweeping reforms this year. MASA leadership and lobbyists are continually working with Alabama’s Congressional Delegation on behalf of physicians as more HSR details emerge. From the currently available HSR information, MASA has a number of concerns with certain health reform proposals.

Despite President Obama’s insistence on a new public health insurance plan, developing a new plan for Americans who aren’t disabled and aren’t more than 65 isn’t the best solution for expanding coverage to the uninsured. The public plan option is also opposed by private insurers.

One of the most egregious proposals being discussed in Washington right now would mandate physician participation in the public plan if adopted. Physicians already face a 21 percent cut in Medicare payment rates on January 1, 2010, with steeper cuts coming over the next decade. To help pay for HSR, President Obama wants to cut an additional $200-$300 billion from both Medicare and Medicaid over 10 years, on top of the $300 billion cuts already in his proposed budget. Given Medicare’s history and its uncertain future, a similarly-styled public plan, particularly with mandated physician participation, would be devastating.