The True Protection Against Another 3.25% Cut in Medicare Reimbursements.

Under the guidance of the American Medical Association (AMA), physician reimbursement has dropped by 26% relative to inflation.  This year, Congress is preparing to cut Medicare reimbursements to physicians by another 3.25% on top of the 2% cut that took place in 2023. 

Calling the situation unsustainable, the AMA wants to “lead the way” in counteracting these cuts. 

But remember, it is because of the AMA’s flawed representation that physicians find themselves in this situation in the first place!  The last time the AMA was entrusted with representing physicians in “fixing the Medicare reimbursement problem,” the challenge was the SGR or the “Sustained Growth Rate” formula whose implementation the AMA failed to prevent.  As a result, physicians were caught in a vicious cycle of recurrent Medicare reimbursement cuts adding up to over 20%.  Unable to repair the system, Congress recurrently enacted temporary fixes, sometimes lasting no more than three months.  The system had become so unstable, that the care of America’s seniors was palpably threatened! 

When the opportunity for a permanent fix presented itself under President Barrack Obama, the AMA, claiming to represent America’s doctors, agreed to endorse Obamacare (with which nearly half of AMA members did not agree) absent any commitments from the Administration other than a vague agreement “to fix the SGR.”  It’s cooperation with the Obama Administration—the AMA assured the medical profession—would mean a permanent solution to physician woes stemming from the then-existing Medicare reimbursement crisis. 

The result, however, was far from it, and physicians got “meaningful use” and MACRA, which eventually led to MIPS. 

An end to physician woes the AMA’s efforts was not, as we saw and continue to experience a precipitous increase in physician retirements, suicides, and a massive egress of members from the AMA. 

Now, the AMA, representing less than 20% of physicians, wants to lead again in the fight to correct Medicare reimbursement formulas. 

The problem is that the AMA is unable to lead physicians because it is too busy waging woke battles such as its efforts to remove sex designations from the nation’s demographic documents, convince the American public that neither sex nor race are genetically associated traits, arguing that Americans have “stolen the wealth of African American for the past 400 years” pushing the position that “we live in lands taken by indigenous people,” and raging that physicians are inherently racists, whether they know it or not.

The United States Medical Association has a different approach.  Instead of propagating the incestuous relationship with government that only interferes with our abilities to care for patients and makes our practices’ financial health suffer under the whims of politicians, let’s break new ground. 

For starters, we believe that a physician-based professional organization ought not represent the interested of insurance companies, bureaucrats, and politicians.  Rather, it ought to represent doctors! 

Instead of a fee-for-service reimbursement model, let’s have the physician reimbursed for the work he or she actually does.  Instead of mandated fee schedules, let’s have physicians work that out directly with their patients.  Instead of having Medicare mismanage the market, let’s have balance billing.  Instead of linking any increase in physician reimbursement to payments across the other medical sectors, let’s undo the ties between budget neutrality and physician payments.  Let’s get rid of EMR mandates, allow for physician hospital ownership without restrictions, achieve parity with hospital reimbursement rates, and while we’re at it, let’s get rid of the fake Maintenance of Certification requirements and provide tax and liability protections for physicians caring for Medicare patients.  

These reforms are achievable, but not with the AMA at the helm.  In fact, the only way to make our voices heard in this arena is by massively growing the numbers of the organization truly in a position to serve as the voice of America’s doctors: the United States Medical Association!

Won’t you join us and help us effectively check whatever crazy ideas the AMA may agree to in the name of the medical profession?

Let’s not allow past errors to be repeated.  Join the USMA, now!  Together, we can work to dismantle the harms imparted upon our beloved profession by the organization representing us in name only. 

Visit the USMA by going to usmedicalassocation.org, or our sister organization, USMAAction.org and join us.  Let us save our profession for ourselves, our patients, and our posterity. 

Dr. Julio Gonzalez is an orthopaedic surgeon practicing in Venice, Florida, and a former Florida State Representative.  He is President of the United States Medical Association.