Medicare to Enforce Profiteering at the Bedside, Writes Physician in Journal of American Physicians and Surgeons

Mar 14, 2016, 13:24 ET from Association of American Physicians and Surgeons (AAPS)

TUCSON, Ariz., March 14, 2016 /PRNewswire-USNewswire/ -- In the guise of "value pay" or "value purchasing," the new Medicare payment system will reward doctors for not ordering services. This amounts to "a corporate or government agency profiteering, i.e., taking advantage of a situation to make a self-serving profit by corrupting the provision of care," writes Robert Geist, M.D., in the spring issue of the Journal of American Physicians and Surgeons.

"Advocates of managed care have long believed that cost control necessitated a switch of professional loyalty from patients to corporate populations," he writes. Previously forbidden and unethical, the corporate practice of medicine has been legalized. Federal laws against kickbacks and self-referrals have also been overridden. Medicare is turning doctors into bedside rationing agents.

The enabling act is the "doc fix," the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which replaced the Sustained Growth Rate (SGR) formula and its yearly threats to drastically cut doctors' pay.

MACRA's Merit-Based Incentive Payment System (MIPS) hides its agenda to deny care behind euphemistic double-speak, such as "bonus opportunities"—meaning bribes to gatekeepers. As George Orwell wrote in 1946, "Political language…is designed to make lies…truthful and murder respectable."

"What happens to the ethical integrity of a nation and its professionals when leaders create a system where doctors are bribed to restrict care at the bedside for the benefit of third-party payers?" Geist asks.

"Value pay" conveys an image of social concern, Geist writes, but it actually gives enormous contracting power to payers—the "power to transfer insurance risk and the black hat of profit-driven rationing of care to providers at the bedside."

The government regulator is supposed to guard against such consequences, but has been coopted into collusion. "The Obama Administration has winked at and abetted rotating chairs between the CMS regulator and the regulated HMO industry management." When former Medicare regulator Marilyn Tavenner became CEO of the industry trade association, President Obama promptly nominated Andrew Slavitt, an HMO (UnitedHealth Group) executive, as the new interim CMS regulator.

The system is creating a conflict of interest between doctors and patients. Geist concludes that a good end, such as cost control, "never justifies corrupt means, a scandalous system of legalized profiteering at the bedside."

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.


SOURCE Association of American Physicians and Surgeons (AAPS)