Josi: Failure to fix Medicare payment system could lead to socialized medicine

The nation’s Medicare physician payment system has been broken for a long time. Don’t believe me? Ask any doctor from any specialty. Every one of them will agree.

Now, another round of arbitrary cuts to Medicare physician payments for care provided has gone into effect, putting our healthcare system on an even more unsustainable path and threatening patient access and choice for millions of Medicare beneficiaries. Unless Congress takes corrective action immediately, growing instability within the Medicare physician payment system will only help support the nation’s march to socialized healthcare — “Medicare for All” — that many have been championing for years.

To shift the tide, Congress must stabilize the Medicare Physician Fee Schedule quickly to ensure America’s doctors are fairly compensated for the actual cost of providing care in today’s economic climate and prevent us from inching closer to a government-controlled healthcare system. Doctors are our last line of defense for turning healthcare into a single-payer system.

Physicians are just beginning to feel the last round of Medicare payment cuts — this one totaling 3.37 percent — that went into effect January 1. These cuts come on top of three additional years of consecutive cuts to Medicare physician payments and roughly two decades of flat payments.

According to the American Medical Association, Medicare payments to physicians have declined 30 percent (2001 to 2024). Moreover, physicians are the only type of care provider who doesn’t receive an annual Medicare payment update that accounts for inflation — making it exceedingly difficult for physicians and practices to keep their doors open.

As a result, many feel they have little choice but to sell to hospitals or larger healthcare systems and become salaried employees. Most doctors used to be small-business owners, a wonderful thing for competition, innovation, generous time spent with patients, and patient choice.

But in the last few decades, healthcare consolidation has accelerated. Today, 50 percent of physicians are employees of large practices. This potentially limits patient access to care, especially in many rural and underserved communities where resources are already scarce.

Further, as patients are forced to move from smaller community physician practices to larger hospital systems to access medical services, their overall costs for healthcare increase. That is because the care provided in the hospital setting is compensated at much higher rates by Medicare than similar services and treatments provided in the physician’s office. These ever-increasing costs give another reason to push for socialized healthcare.

Amid vociferous calls from some for socialized medicine schemes, doctors who do not own their own practices may feel less urgency to fight a government-run healthcare system. In other words, physicians may soon be worn down by decades of payment cuts to accept “Medicare for All” — a devastating development for the nation’s healthcare system.

Congress must take quick action to reverse the Medicare payment cuts that physicians face, and then work to pass long-term, sustainable Medicare reform to protect the integrity of our healthcare system and prevent Medicare for All.

Fortunately, a bipartisan group of lawmakers has introduced the Preserving Seniors’ Access to Physicians Act (H.R. 6683). If enacted, it would fully reverse the latest dangerous cuts and prevent them from doing further harm to physicians and patients.

Congress should pass H.R. 6683 as part of its must-pass funding legislation and then work to implement commonsense reforms that will fix other issues plaguing the Medicare physician payment system. These reforms must include implementing annual payment updates to better align physician reimbursement to inflation as measured by the Medicare Economic Index, the same way all other providers are treated under Medicare.

Medicare is far from perfect, but most will agree that it would be far better to address the current issues within the program and its payment structure than to scrap it all for full-blown socialized healthcare. Leaders in Congress must work to fix the broken Medicare physician payment system to help protect and support privately owned practices that are the backbone of our healthcare system.

Christian Josi is the founder and managing director of C. Josi & Co., a public affairs consultancy.