Medicare Is Already Rationing Care
by Dr. C.L. GrayRationing Medicare will not require clandestine meetings in smoke filled rooms. Simply reduce physician reimbursement to below the cost of delivering quality care, and free market forces will take care of the rest.
Medicare has already begun the process of backdoor rationing. Facing overwhelming budget shortfalls, Medicare needs to trim its books. Washington found a clever solution: eliminate the billing code for “physician consults.”
As a hospital physician, I often admit Medicare patients with chest pain or shortness of breath. If my patient needs urgent help from a cardiologist, I call a colleague for assistance.
Until December 31, 2009 the cardiologist could charge a “physician consult” fee for getting out of bed, coming to the hospital, and evaluating a patient with a potentially life threatening problem. Medicare paid $195.76 for this middle-of-the-night work (the same rate as when done during the day).
By eliminating the “physician consult” billing code, Medicare now advises the specialist to charge for a “hospital admission.” For two more months, Medicare will pay $175.67 for this service. However, without a change in current law, the physician’s reimbursement for a “hospital admission” will drop to $141.63 on March 1. This is why the “Doc Fix” is so important for working physicians and their Medicare patients.
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