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"Doc Fix" Debate 2013 Begins

It's only been a couple of days since the announcement of the bipartisan budget compromise. But, it's now the job of the Congress, like it typically does, to avoid the crisis of being in Washington DC for Christmas, by debating other financial issues. According to The Hill, today's items include a one-month farm bill extension, the National Defense Authorization Act, and a three month "Doc Fix."

"Doc Fix" is the euphemism used as a piece of legislation to avoid double digit cuts in Medicare payment to physicians. This topic has been written about on this website many times in the past. This time, I believe this will be around 25% congressionally mandated cuts to Medicare physicians. The graph below from politisane last year shows the proposed negative direction of medicare payments to the positively growing cost of inflation to keep a practice open.

Physician advocacy groups, like my own American Academy of Family Physicians, have been doing a lot of lobbying on Capitol Hill. They have been talking to legislators not only about avoiding the short term cut, but also coming up with a long term solution to fix the broken Medicare payment system (#fixSGR on twitter).

Current Congressional debate will be changing an approximate 25% cut in Medicare payment to a whopping 0.5% increase (that's zero point five percent) increase in Medicare payment - just through March 2014 - when we'll have to go through this political exercise again (possibly attached to the debt ceiling debate).

So, semi-political junkies like me will be viciously following sites like The Hill for the latest updates. But, all of us know what is going to happen. With the 2014 midterm elections just around the corner, neither political party is interested in any kind of long term solutions to things like the broken Medicare payment system.

Manufactured political crises, short term political deals, and pundits like me will continue to use phrases like "bandaid solution" and "kicking the can down the road."

Where will it end? Well, you're already seeing proactive people just getting out of this broken health care system with health care solutions like Direct Primary Care and concierge care. Is this the future? The one thing all of us can agree on is that our current path is unsustainable. If government doesn't solve the problem, grassroots medicine will...