Hi Billy,

On Mar 26, 2012, at 2:37 PM, [email protected] wrote:
>> Finally, the CPC budget would prevent the 27-percent cut to physicians’ 
>> payments under Medicare that is scheduled to be imposed in calendar year 
>> 2013. This automatic cut resulting from the sustainable growth rate (SGR) 
>> mechanism installed in the 1990s has been avoided in recent years by 
>> providing offsetting deficit reduction – referred to as the “doc fix.” CPC 
>> includes and fully pays for this “doc fix” over 10 years, preventing the 
>> physician payment cut.
>  
> This is nonsense, all doctors should be required, as part of their licensing, 
> to provide medical services to X number of  patients under Medicare. This 
> would be a "sacrifice"? Like hell. I simply cannot feel pain for people 
> earning $ 150,000 or $ 250,000 when they are asked to chip in for the 
> national good and the well being of people who live at the poverty level.

Fine, but for what level of "X"?  10%?  50%?  90%?

The problem is that Medicare patients are not evenly distributed 
geographically.  Do we bus patients around to de-segregate them?

I agree, our current pseudo-market system of health care is a general disaster 
all the way around.  But underpriced Medicare patients don't just cost doctors, 
they also cost nurses, clinics, non-profits, etc.  Who pays them?

If you wanted to just propose a, say, 10% surtax on medical professionals 
making more than $150,000 and use that to fund Medicare coverage, that would 
probably be more equitable.  Otherwise, the decline in payments is an effective 
tax on those doctors who *are* willing to take Medicare, and enforcing quotas 
is a bitch.

E

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