Point of View

Cutting Medicare payments to doctors is playing politics with patient care

March 10, 2014 

Once again, Medicare fees for physician services are set to be cut – this time by 23.7 percent on April 1. This unrealistic cut in payments could jeopardize North Carolina Medicare patients’ access to care because many physicians would not be able to afford to see new Medicare patients.

We seem to face this threat every year, but this year could be different. A solution appears within reach through the advance of the Sustainable Growth Rate Repeal and Medicare Provider Payment Act of 2014. Congress can stabilize the Medicare program and transition to a program based on the quality and value of the care provided rather than on the quantity of procedures, services or tests ordered.

The Sustainable Growth Rate was enacted by Congress in 1997 as part of the Balanced Budget Act. Devised as a way of controlling Medicare costs, it set a target for annual increases in Medicare spending on physician services, and if those targets were not reached, it mandated a cut in payments for physician services the next year to hit that target. The targets proved to be unreasonable, leading to mandated cuts that had to be temporarily fixed every year by an act of Congress.

Congress has spent an estimated $154 billion on 16 temporary fixes or “short-term patches” in the last decade. These patches are the equivalent of paying the minimum on your credit card bill – it delays the inevitable, increases the total bill and is bad for the budget. Without a true fix, we will be facing yet another short-term “patch,” in which the cut is temporarily rescinded. That would neither solve nor move us closer to solving the Medicare physician payment crisis.


We need to fix this broken Medicare payment system once and for all.

Over the last year, congressional leaders have led a bipartisan, bicameral and inclusive process to reach consensus on how to repeal SGR and reform the Medicare physician payment system. They allowed the members of the medical community, including the American College of Surgeons, to work as partners with them to help resolve this difficult issue.

Together, not only have we found a way to repeal SGR, but we also have been able to streamline existing quality programs, encourage alternative payment models and move toward a value-based system that rewards high quality, efficient health care.

Moreover, this legislation is supported by the vast majority of national and state medical organizations. Physicians have kept their promise to unite around sound policy reforms that will help build a more sustainable, fair and efficient Medicare physician payment system. And it will help create a learning health care system that continually improves the health outcomes of individuals and populations.

It is time for our representatives to keep their promise and support and pass this landmark legislation. Our representatives must make sure that this legislation stays on track and becomes law. The American College of Surgeons and its more than 79,000 members stand ready to work to help achieve that end.

We need to stop stalling and playing politics with the Medicare program and its beneficiaries. It’s time we repeal SGR and resolve the Medicare payment crisis. Our reward will be a patient-centric, quality-based health care system that’s efficient and affordable. That’s good for everyone, especially patients and taxpayers.

Mark C. Weissler, M.D., is vice chairman of the Board of Regents of the American College of Surgeons and a professor at the University of North Carolina at Chapel Hill.

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