Every doctor who graduates medical school takes the Hippocratic Oath and pledges, “First do no harm.” Heroic health care workers have lived up to this pledge across the country, risking their own lives treating patients suffering from the deadly COVID-19 pandemic. Unfortunately, policymakers in Washington are violating this oath by going forward with planned cuts to physician pay that would do substantial harm to our health care system.
Beginning January 2021, the Center for Medicare and Medicaid Services (CMS) will drastically reduce payments to doctors who treat patients covered by Medicare. CMS already reimburses doctors far below the cost of care. Our health care system, which is currently facing the strain of a global pandemic, needs all the resources it can get.
If this misguided rule goes into effect, estimates show that cardiac surgeons will see a 9 percent cut, thoracic surgeons will see an 8 percent decrease, and vascular surgeons will face a 7 percent decline. These cuts will have a lasting effect since Medicare patients often make up a major percentage of in-person treatments for many doctors.
An arcane budget rule is responsible for this situation. Current law mandates that any changes to CMS funding must be budget neutral. CMS is rightly increasing funding for remote telehealth consultations during this pandemic, in order to reduce in-person contact between patients and their health care providers. But budget neutrality mandates that CMS must offset these telehealth fund increases from elsewhere, and frontline providers are shouldering much of this burden.
Budget neutrality may be a prudent cost control measure in normal times. But forcing frontline physicians to cut costs in the middle of a global pandemic is misguided and downright dangerous.
Across the country, physicians, hospitals, and clinics are facing a financial crisis along with a health care crisis. Back in March, state and local governments nationwide mandated that hospitals and clinics cancel or postpone voluntarily in-person procedures to slow the spread of COVCID-19. Although this was a prudent move at the time, it resulted in a massive decline in patient visits that physicians depend on to keep the doors open.
Emergency departments saw a 50 percent decline in patient volumes, even when factoring in COVID-19 patients. Many specialties, including anesthesiology, saw patient volume decline as much as 70 percent. With fewer patients coming in for treatments, many physicians, clinics, and hospitals were forced to lay-off or furlough workers. Since February, more than 800,000 jobs have been lost in the health care sector.
This financial pressure will have long term consequences. A recent survey conducted by the Surgical Care Coalition found that one in three private practices are concerned that they will have to close their doors. Hospitals and clinics in rural and underserved communities are especially at risk. Our health care system cannot afford any more financial strain.
Fortunately, Congress has the power to stop these cuts from occurring. Our delegation — including Senators Roy Blunt and Josh Hawley — should pass legislation instructing CMS to forgo the budget neutrality requirement. This would ensure that both telehealth operations and frontline physicians receive critical and necessary funding in the midst of the COVID-19 pandemic.
The public comment period for CMS’ decision runs through October, giving us precious little time to convince policymakers in Washington to change course. I urge members of our community to contact their senators and representatives and implore them to cancel these devastating cuts to our health care system.
Our doctors, nurses, and health care workers heroically stood on the frontlines of the pandemic as millions of Americans suffered from this deadly virus. These heroes cannot afford to carry the burden of misguided and deadly budget cuts.
Joel Ray MD, FACS recently completed a 45-year career in medicine, the last 22 as a neurosurgeon practicing in Cape Girardeau. Dr. Ray has held numerous positions including Chief of Neurosurgery at Naval Hospital San Diego, Associate Professor of Neurosurgery at UCSD, and twice the President of the American College of Surgeons, San Diego Chapter.