This past year has seen a tremendous number of changes in the health care industry. The entire health care reform debate raged and ranted, whined and squeaked and finally got signed. There have been strings of action and inaction, push and pull, Congress extending physicians’ payments for a month at a time, (when they could as easily have applied a six-month bandage) as the administrative offices played catch-up with the paperwork. But last month, that all stopped. The administrative agency declared that they would NOT pay on the presumption that Congress would fund it retroactively… and since then, Congress has done nothing to resolve the problem. That’s right. Doctors have simply been working for 21% less, trusting our government to make it right eventually. But this time, it isn’t happening.

There has been no notable effort on the part of Congress to fund the 21%. In fact, they aren’t even talking about it. It would seem they’ve just decided that doctors can afford to take a 21% reduction in reimbursement for their Medicare patients. News Flash, Congress: THE MEDICAL COMMUNITY CANNOT PROVIDE SOCIALIZED MEDICINE. Doctors cannot afford to work for 21% less than the psaltery sum that Medicare was paying. This isn’t just a matter of being willing to work pro bono. We’re talking about 21% off of break-even rates. We’re talking about a doctor taking 21% of each Medicare patient’s bill out of his pocket every time a Medicare patient walks out of his office. Sorry, can’t be done. You can’t do it, Congress, so you’ll certainly understand that we can’t either.

Think this is just hitting doctors hard? Think again. Don’t be surprised when you walk into your doctor’s office one of these days and they either can’t see you, or present you with a bill for the part that Medicare no longer covers. Have you been paying for supplemental insurance that picks up whatever Medicare doesn’t pay for? Best grab half a glass of red wine and have a seat. Your premiums are about to take a big huge jump. They’ve gotta pay for it some how, from some where. Guess where the buck stops. We’ll give ya a hint: It’s not the government, it’s not Medicare, it’s not your insurance company. And your doctor can’t afford to gift it to you.

So you will soon be looking at a 21% increase in your premium, right? WRONG. We wish. That’s 21% of the whole bill, not just 21% of the premium. It’s 21% of your medical bills. That (plus administrative costs, of course,) is what it’s going to cost you out of pocket for our Congress to procrastinate, to continue to refuse to keep their end of the Medicare bargain. Want to see a doctor? Good luck figuring out how to pay for THAT change on a fix income budget.

The most immediate and obvious consequence of Congress not re-funding the payments, though, is likely to take the form of lines. Not lines on your face, the lines to get in at the few doctors who will still accept Medicare “for a little while longer.”

As we make our way through changing times, it’s certain that access to care is going to be the first major casualty. We told you there was a storm coming, remember? Well it’s begun raining… and that storm doesn’t care if you’re a physician trying to pay the rent or a patient in need of crucial care. If this isn’t the sort of change you had in mind, there is no better time than the present to take a stand, to demand that Congress take care of its obligations to the American people.

This post marks the beginning of a series of discussions regarding the future of healthcare under the new system. Check back often, and please do chime in. Let us know what YOU’RE thinking. The only way any of us are going to survive this is by working together.