Unites States Budget and Health Care; A Connection?

The president recently unveiled his budget proposal for the coming fiscal year.  It makes for some very interesting reading.  The section of the proposal that describes, by item, the increase or decrease and it impact on the deficit is especially fun to review  If you’re interested here’ a link; http://www.whitehouse.gov/omb/budget/Overview/. You can review the budget summary or by specific department.

Of interest to me of course, is the area related to health care.  Actually, given the enormous debt associated with the health care bill, and it’s immediate negative tax consequences, it should be of interest to you also.  The budget makes projection on future deficits showing some slight decreases but even 10 years out, no real reduction in the National debt.  It also assumes an increase in tax revenue.  With the current rate of unemployment and the  economy in the its current shape, the only way revenues will increase is by raising taxes.

As a physician, I’m the recipient of a double whammy.  Not only are physicians a routine and regular target of the press and the tax man, but also Medicare.  Reports generated by CMS (Centers for Medicare and Medicaid Services), consistently talk about the “increases” in payments made to physicians from both the public and private sectors.  Their last report stated a 9.9% increase.  I didn’t see that in ANY payment from Medicare or private insurance.  And NO WAY will you ever see an increase in Medicaid.

In fact, Medicare is fudging the data a little to make physicians an easy target.  MEDPAC (Medicare Payment Advisory Committee) is the independent Congressional agency formed to develop and report the studies that are used by Capitol Hill and all the news agencies who report on these issues.  But, if you look into the ENTIRE report, like I did, you find some very interesting facts.

In the most popular version of the reports from 2008 or 2010, physicians are lumped together with “…other clinical services”.  I couldn’t find a definition for their clinical services so I continued to dig to separate physicians from “clinical services” to see what impact, if any, Physicians truly have on the total of Health Care Expenditures in the US.

I found a full copy of the MEDPAC report on their website.  It states that in 1999 “Fee Schedule” payments to physicians accounted for 16% of Medicare dollars spent.  But, in 2009 that value was only 13%  In their official 2008 report that almost all the presidential candidates spewed out of their mouths during the last election, repeatedly reported “physicians were responsible for 22% and that figure was an increase of 9.9%.  There may have been an increase in that category, but it was for ….other clinical services.  Rather an unfair representations.  I think it was done purposely to help demonize physicians and make them an easy target for fee reductions.

You’d think that the AMA (American Medical Association) would be looking out for its physician members.  But you’d be wrong.  The AMA spews the same data as everyone else, despite the fact that it misrepresents every physician in the US.  That means that their article published as Health Care Trends 2008 has no one looking any more deeply int the reported data than the seemingly corrupt congress we have in Washington.  The Tea Party is making headlines all across the US because the citizenship has had enough.  Corruption, taxation without representation, Capitol Hill turning a deaf ear on their constituency. Washington has lost touch with the people.

If we the people have incompetent representation from all of our leadership, who or what are we to believe?  And how can we ever make ANY intelligent decisions, especially about our national leaders?

Doc B

My opinion is free

Advice is worth exactly what you pay for it.


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