For their voters, Congress should increase Medicare payments and oppose Medicaid
As an ENT practitioner practicing in the Bronx, New York, I have witnessed first-hand the adverse effects of inaccessible care – advanced cancers should have been caught earlier and have now become incurable and inadequate conditions such as hearing loss or dizziness can make the scale hired from unemployed unemployment. I looked around and wondered if this would be a year due to the cuts proposed by Congress, which forced the benchmark or heart disease office to close the block.
The substantial cuts in Medicaid and Medicare proposed by Congress will increase waiting time, leading to more dispersed or non-existent care, and lead to unnecessary death and despair.
Health care is a human right, and the lack of access to health insurance means that many people seek care only after their health has become so compromised that they have to seek emergency care. The problem with many rural communities is that these cuts will shut down hospitals and emergency rooms, leaving patients nowhere to go. This means spending hours on the road seeking care of the suffering person in the back of an ambulance or passenger seat.
As doctors, our obligation is to care for those who need us – sick children, disabled people, nursing homes, veterans, people with chronic diseases, mental health and other special needs. Providing care for our patients is the reason why we go to medical school and spend years in residency and scholarship training. The idea that these cuts will prevent our patients from getting the care they need is deeply troubled by us.
The huge potential cuts under House and Senate settlement recommendations will be identified by creating significant new reports and administrative burdens that could cause many to lose their coverage, thus disproportionately harming at risk and rural communities. It will unfairly punish those countries that choose to spend their money to expand the care of those living in their states, which will greatly undermine the stability of our community physician practices, through the new copay obligation to pay for care for countless limited financial expenses.
In many states, including New York, most children rely on Medicaid for health insurance. In many families in rural areas, people are more likely to be uninsured and face challenges in accessing much needed health care. Medicaid covers more children and adults in rural communities than in urban areas. It also provides financial security for low-income working families who cannot afford coverage or do not provide for their employers. Rural health care is already in crisis across the country, and these cuts will shut down rural hospitals and nursing homes and opportunities to address nursing challenges as more and more providers are forced to leave. It is in everyone’s interest to reduce waste, fraud and abuse and become a good steward of taxpayers’ money – including the New York Doctor – but it’s too far, too fast, and not enough time to adapt to the new routine.
It’s bad, and this settlement proposal closed by the House would severely cut New York’s Medicaid and threaten millions of opportunities to lose health insurance and access to care. Now, the U.S. Senate program doubles down on our healthcare system. They want to cut Medicaid further, and they don’t address the devastating Medicare cuts imposed on doctors over the past few years to catch up with our predecessors. At least the House bill has begun to address this profound problem by binding payments for medical inflation.
We are very frustrated that Congress will not offer inflation-based adjustments to physician payments like Medicare benefits and hospitals do. By implementing years of cuts, while inflation and health care costs soar, the health insurance system has fundamentally destroyed. Medicare physician compensation has dropped by nearly 33% over the past 24 years, while the cost of running medical practices has increased by 60% due to inflation and soaring costs.
Hospitals get inflation adjustments. Even the Medicare Advantage program, which is reportedly under criminal investigation, will undergo inflation adjustments. But physicians have been receiving wage cuts over the past 20 years.
No wonder the doctor’s waiting time is rising and private practice is closing? Congress needs to focus its valuable resources on adequate funding of physicians and providers’ payments, so we have the resources to fix the injury immediately before the disease causes expensive hospitalizations so that individuals can resume work and avoid disability and restore hearing or other accommodation to restore individuals’ employment and self-esteem.
Doctors in New York State have improved the health and well-being of all New Yorkers. We hope Congress ensures sufficient funds.
Photo: Alexsl, Getty Images
David M. Jakubowicz, MD, president of the New York State Medical Society (MSSNY), is the director of otolaryngology and allergy at Essen Medical and an assistant clinical professor at Otorhinolaryngology, clinical assistant at Albert Einstein Medical School/Montfield.
Dr. Jakubowicz received his Bachelor of Science in Biology from Cornell University and his PhD in Medicine from New York University School of Medicine. Dr. Jakubowicz is part of the Maimonides Physician Leadership Program. He was then recruited to serve as the chairman of the otolaryngology department in the Bronx, Lebanon, and later as its or committee chair. Dr. Jakubowicz is also the Director of Otolaryngology and Allergy at Medalliance Medical Health Services and is a member of the American College of Otolaryngology Allergy, the American College of Surgeons, and the American College of Head and Neck Surgery. Dr. Jakubowicz has served on MSSNY and the Bronx County Medical Society and is currently a representative of the American Medical Association (AMA).
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