Since Fox News was among the most notorious purveyors of “pants-on-fire” lies about health care reform, it's no shock that they are still trying to spin any health care development as “rationing” from “Obamacare.”
That's exactly how Fox & Friends treated a weeks-old announcement from a Medicare advisory board this morning. It is true that earlier this month, the Medicare Payment Advisory Commission (MedPAC) voted to endorse a plan that would permanently repeal the much-disliked sustainable growth rate (SGR) formula for reimbursing doctors -- and, yes, would also call for some cuts to physician payments. But the recommendation is just that -- a recommendation. MedPAC has no ability to enforce this plan; only Congress could do that. And the cuts would be part of a plan that prevents a 30 percent across-the-board decrease currently scheduled for January 1.
Yet, co-host Brian Kilmeade began today's segment by claiming that "[d]octors across the country are about to see their Medicare payments slashed big time." Fox News contributor Dick Morris then claimed that MedPAC's recommendation is “the implementation of Obamacare” and said: " 'Advisory' [in MedPAC's name] is really a misnomer. It's the law."
From the broadcast:
KILMEADE: Doctors across the country are about to see their Medicare payments slashed big time. Earlier this month, a government advisory commission voted to repeal the formula that sets physician pay rates, replacing it with a new plan that cuts Medicare payments for both nonprimary and primary doctors. Joining us now to talk about the implications is this, former adviser to president Bill Clinton and author of the bestseller Revolt, Dick Morris. Welcome back. Dick, how -- what should we know about this that's different from Obamacare?
MORRIS: Well, this is the implementation of Obamacare. This is an agency called the Medicare Payment Advisory Commission. “Advisory” is really a misnomer. It's the law. The decisions of this commission do not have to be ratified by Congress. They can be overridden by Congress, but they don't have to be ratified, and they are imposing this. They have decided that they will cut reimbursement for specialists by 16 percent over three years, and then freeze those payments for seven more years regardless of inflation. So if you have about a 3 percent-a-year inflation rate, that's 30 percent plus the 16 percent comes to almost a 50 percent pay cut for specialists. For general practitioners, there's no cut, but there's a 10-year freeze regardless of inflation. And again, if you assume inflation at 3 percent a year, which is very low, that's a 30 percent cut.
MORRIS: So what it really is going to do is cut the pay of specialists in half and of primary care doctors by a third.
Kilmeade then asked, “Who is going to want to be a doctor?” and Morris claimed: "[T]he result is that if you're on Medicare, you probably can find a general practitioner. But if you have cancer, you're never going to see an oncologist. If you have heart disease, you're never going to see a cardiologist." From the show:
KILMEADE: It's just going to rock -- it's going to rock the medical world big time. Who is going to want to be a doctor? Go rocketing --
KILMEADE: -- into debt, and then find out that this is what you're going to be paid back. And it's almost like social work.
MORRIS: It's not just that. It's going to force doctors out of the Medicare program. They're going to say no, I'm not going to take Medicare patients. And the result is that if you're on Medicare, you probably can find a general practitioner. But if you have cancer, you're never going to see an oncologist. If you have heart disease, you're never going to see a cardiologist.
KILMEADE: It's because they're not going to get paid, and they're not going to show up.
On-screen text that aired during this conversation read:
Kilmeade then tried to change the subject to talk about GOP presidential nominee Mitt Romney, but Morris wasn't done fearmongering about supposed “rationing” :
MORRIS: But let's get back to the Medicare thing. This literally threatens the whole future of our health care, because Medicaid will probably follow and then the insurance companies will follow. You're going to have fewer doctors, more rationing. You'll probably see nurses and physician assistants instead of doctors, and most importantly, you won't get to see a specialist even if you have a serious illness. On my website DickMorris.com --
KILMEADE: Dick, hold that last thought, because we're going to carry over.
MORRIS: -- I have a petition to overturn these cuts, so I'd urge people to visit it and sign.
KILMEADE: Go to DickMorris.com.
Here's an excerpt from that petition (emphasis added):
The worst fears about Obamacare are now being realized in a decision on Monday by the Medicare Payment Advisory Commission (MPAC) established by the law to supervise $500 billion in Medicare cuts. MPAC, whose decisions have the force of law, has voted to impose drastic pay cuts on all doctors under Medicare and, by extension, under Medicaid (which tends to follow suit). The cuts will effectively reduce the real pay for specialists by 50% over the next ten years
including a 25% reduction over the next three years -- and cut general practitioners' pay by one-third over ten years (and that assumes that inflation stays down at 3% a year).
This is so false it would be laughable if it weren't so dangerously misleading. First of all, MedPAC has nothing to do with “Obamacare” and was not “established by” health care reform. It was established in 1997, as its website explains, to “advise the U.S. Congress on issues affecting the Medicare program.”
Second, the plan is not “law” at all, because MedPAC's recommendations do not “have the force of law,” as Morris' petition claimed. Here's an October 6 article from MedPage Today, a medical news service, about MedPAC's recommendations (emphasis added):
The Medicare Payment Advisory Commission (MedPAC) has voted to officially endorse a plan to repeal the sustainable growth rate (SGR) formula that establishes physician pay under Medicare and replace it with one that keeps rates steady for primary care physicians over the next decade and cuts payments to specialists.
Cost of the plan is pegged at $200 billion, and the commission laid out ways to pay for it.
The proposal will reach Congress later this month. If Congress does not act on the MedPAC plan or come up with an alternative before January 1, a 30% across-the-board cut in Medicare payments mandated by the SGR will go into effect.
Congress doesn't have to act on the MedPAC plan, although it does have to do something if it wants to prevent the “30% across-the-board cut in Medicare payments” from going into effect. Why? It's because of the way physicians are currently paid by Medicare, under a formula called the sustainable growth rate, or SGR. That formula was passed as part of the Balanced Budget Act of 1997 -- it was not part of health care reform. Physicians more or less universally dislike this formula, which, because it connects reimbursements to the GDP, usually ends up demanding cuts to physicians' payments. So each year for the past decade, Congress has stepped in to postpone those cuts, as an October 6 article in Physician's Weekly explains:
The SGR formula connects physician reimbursement rates to increases in the gross domestic product (GDP). Since spending on physician services has outpaced increases in the GDP, the SGR formula required cuts to be made in reimbursements each year over the past decade. However, Congress has always postponed those cuts.
Now, the article explains, under the SGR formula, Medicare payments will automatically be cut 30 percent. Again, that formula was passed under a 1997 law. That's the reason MedPAC is advising SGR be done away with altogether. Unfortunately, its recommendations do also include some cuts to physician payments -- though those cuts are part of a plan that would prevent the 30 percent across-the-board decrease. As the Physician's Weekly article explains:
The Medicare Payment Advisory Commission (MedPAC) has officially endorsed the repeal of the sustainable growth rate (SGR) formula, which determines physician payments from Medicare, in hopes of replacing it with a 10-year fixed rate for primary care physicians and cuts in payments to specialists.
Come January 1, an SGR-triggered pay cut of 30% in physician reimbursement is scheduled -- a price too high to sustain physician participation in Medicare, particularly primary care providers. As a result, cuts were recommended only for specialty providers, while freezing reimbursement rates for primary care physicians.
The endorsed plan to repeal the SGR formula will cost around $200 billion; MedPAC has developed strategies to pay for it. The proposal will reach Congress later in October. If Congress doesn't act on the plan or develop an alternative before the first of the year, a 30% cut in Medicare payments mandated by the SGR will be implemented across the board for all providers.
So it's clear that congressional action is needed to address physicians' Medicare payments. But that action is not “Congress ... overrul[ing] the MPAC decision” as part of the “Obamacare ... War On Doctors,” as Morris's petition demands. There is no “MPAC decision,” and this issue has nothing to do with “Obamacare.”