Monday, November 21, 2011

Super Committee To Physicians: Go Texan or Go Dishwasher

Room for one more!
Once again, the Disease Management Care Blog got it right: the prognosis for the Congressional 12-person Super Committee was only slightly better than the likelihood that the DMCB was a Justin Bieber love-child.  How could the Committee ever succeed with the 13th Man being elsewhere overseas, while Dr. Krugman on the left and the WSJ's editorialists on the right were both agreeing that any deal would be Satan's spawn?

But if budget cutting is a good thing, why are the equity markets down?   In addition to the lingering threat of an eventual Moody's downgrade, the DMCB suspects stock holders a) have calculated a $1.2 trillion budget cut was never really up to the task*, and b) fear that the 2012 Congress won't stick to its guns.

So, asks the DMCB, what's next? 

Automatic cuts will be applied to discretionary federal spending as well as the defense budget.  While Medicaid is spared (much to the relief of our nation's governors), Medicare is facing a 2% sequestration which, because premiums and cost sharing will go untouched, translates into payment cuts for hospitals, doctors and other providers.  An additionally toxic wild card is a looming additional "SGR" 27.4% Medicare physician fee schedule cut.

How will the DMCB's physician colleagues react to this dysfunction? 

Not well:

1) for those in physician owned practices, it may come down to deciding whether or not to go postal Texan.

2) for those in salaried positions, they can look forward to their Administrators turning to the "dishwasher" approach of maximizing patient throughput-dependent revenue: there's always room for a few more.  And if docs expect Uncle Sam to have any sympathy, they need to think again.

Let the games continue.

(HT to George Will)

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