By E. Linda Villarreal, MD, president, Texas Medical Association
What would you do if your employer cut your pay by 10% during one of the most stressful times in recent history? And what if your company did that after not giving you a cost-of-living raise for more than two decades?
Well, now you have an idea of how we as physicians feel about Congress’ plan to cut our Medicare payments by nearly 10% starting in January. It could be worse: Combined with other penalties in the program, the reductions in Medicare payments for services provided in 2022 could be as much as 18% for some doctors.
These are physicians taking care of the nation’s elderly and disabled patients during their most vulnerable time – a pandemic. These are doctors already reeling from the impacts of a 19-month-long public health emergency. They’re exhausted, and they’ve had to dip into their personal savings and capital to keep themselves and patients safe with extra infection control, personal protective equipment, and costly investments in telemedicine for patients who can’t be seen in the office or a typical clinical setting.
This is not the way to reward our physicians who’ve sacrificed tirelessly. It’s like pouring salt on a wounded workforce. Worse than the insult to doctors is the insult to Medicare patients who will suffer when physicians can no longer care for them.
Already, the pandemic has forced some physicians to close their doors and has precipitated early retirements: A 2021 Physicians Foundation survey showed that nearly a quarter of Texas doctors are considering retiring within the next year.
A 2021 Texas Medical Association survey showed that nearly all (93%) of Texas physicians currently accept Medicare patients, yet 63% are considering changing their status to nonparticipating, and 59% are considering opting out of Medicare altogether. In fact, almost 10% have already stopped accepting new Medicare patients. Almost two-thirds – 62% – said they would consider not accepting new Medicare patients, and 42% said they may have to stop seeing existing Medicare patients. Due to delayed preventive care and postponed elective surgeries, about half of physicians have seen an income reduction due to the pandemic.
Physicians need support right now – not a pay cut. Especially not when we’re talking about a sizeable and ever-growing portion of the aging U.S. population in Medicare – folks who are most susceptible to chronic illnesses and infectious diseases like COVID-19 – who could end up without access to a doctor. Not when the pandemic already has exposed deep health disparities and access-to-care problems for racial and ethnic minorities – and for senior citizens.
Some of my most cherished patients are covered by Medicare and have been seeing me for decades. I could hear the fear in one patient’s voice when he asked recently if I was going to retire. I’ve been seeing this patient for 25 years. He counts on me.
We do this because we love taking care of our patients. We do this despite the fact that Medicare has not given us a cost-of-living increase since 2001 – unlike any other profession. Even hospitals are not subject to these types of cuts. And I’ve been doing this long enough to remember some of my colleagues being pushed to the brink and putting up yard signs saying they were no longer taking Medicare patients, because Congress threatened to cut their pay year after year back then, too.
Here we go again.
It’s hard enough to sustain a medical practice these days. Another round of cuts would bleed our physicians dry, and patient access to care will suffer. It’s time for this to stop; time to apply pressure where it’s needed. Congress can and must stop these Medicare physician payment cuts.