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No Agreement on Deficit Plan Means "Peril" for Patient Accessto Health Care
Failed "Super Committee" process must not lead to failed policies, Says American College of Physicians
Virginia L. Hood, MBBS, MPH, FACP
President, American College of Physicians
November 21, 2011
(Washington) The inability of the Joint Select Committee on Deficit Reduction to reach agreement on a bipartisan deficit reduction plan will put patient access to health care in grave peril, reports the American College of Physicians (ACP). Left in the wreckage of the "Super Committee" process are plans to automatically impose unprecedented cuts in health care programs-cuts that will within weeks endanger Medicare beneficiaries' and military families' access to care, and later, cause unsustainable cuts to many other critical programs to reduce disease, protect public health and safety, and ensure that patients have access to doctors:
- On the first of next year, physicians who take care of seniors, disabled persons, and military families enrolled in Medicare and TRICARE will receive a 27.4 percent cut in reimbursement for their services.
- If this cut is allowed to go into effect, physicians will have to consider a range of painful options, including closing their practices; limiting how many Medicare patients that they can see; laying off staff; and postponing purchase of electronic health records and other investments to improve patient care.
- With no "Super Committee" agreement, the Budget Control Act of 2011 requires that the federal budget automatically be cut to achieve $1.2 trillion in savings over the next decade, half of which will come from defense spending and half from non-defense programs. The required cuts to each agency will be announced in January, but won't go into effect until a year later. Federal agencies, though, will have to begin making plans for how they will reduce their services in anticipation of the cuts. The sequestration cuts will endanger everything from military health care to medical research to prevention and control of disease to training of primary care physicians and other specialties facing shortages.
Given the unacceptable consequences of allowing such cuts to be imposed by automatic pilot, ACP calls on Congress to make a course correction:
- First, Congress must enact legislation to prevent the January 1 Medicare cut to physicians. But rather than just enacting another short-term fix that results in deeper cuts and higher costs later on, Congress should view this as an opportunity to take a first step toward a multi-year transition to better payment and delivery models, such as that proposed by the Medicare Physician Innovation Act framework offered last week by Rep. Allyson Schwartz (D-PA). Her framework would result in stable and positive updates over the next five years, provide for an additional increase for undervalued primary care services, and create a timetable for Medicare to evaluate and adopt new models of payment and delivery and for physicians to transition to such models.
- Second, Congress should resume work now-and continue its efforts into the next session-on developing a fiscally and socially responsible package for deficit reduction that addresses the real cost-drivers in health care, instead of imposing arbitrary and dangerous cuts in essential health programs through sequestration. Earlier this fall, ACP provided Congress with a menu of changes in health care policies that could save between $500 billion and $800 billion in federal health care spending, consistent with our own policies. We also called for a national, multi-stakeholder initiative to reduce the estimated $700 billion spent annually on marginal, ineffective and wasteful care.
The failure of the "Super Committee" process need not result in failed policies that will cause incalculable harm to patients. Congress and the administration have an opportunity to change course now, prevent the January 1 SGR cut, stabilize physician payments and support the transition to new physician payment models, and reform federal health care programs in a fiscally and socially responsible way while ensuring continued funding for critical health care programs.
The American College of Physicians (www.acponline.org) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 132,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter (Twitter) and Facebook.