Letter Sent to Congressional Leaders by CMA President, James T. Hay, MD

On December 22, 2011, James T. Hay, MD, CMA president and SDCMS-CMA member since 1985, sent the below letter to the House and Senate congressional leaders and the California congressional delegation urging them to immediately stop the Medicare SGR cut and to develop a longer-term path to an alternative payment system.

Senator Harry Reid
Senate Majority Leader

Senator Mitch McConnell
Senate Minority Leader

Representative John Boehner
Speaker of the House

Representative Nancy Pelosi
House Minority Leader

Dear Senators Reid and McConnell, Speaker Boehner, and Minority Leader Pelosi:

The California Medical Association (CMA) is outraged that Congress went home for the holidays without stopping the Medicare fee-for-service SGR physician payment cut and protecting access to healthcare for millions of Californians. We are writing to urge you, the congressional leadership, to return to Washington, DC, immediately to pass legislation to stop the Medicare fee-for-service physician payment cut. Physicians work and see patients during the holidays, and Congress should get its job done too. The failure to stop the immediate 27.4% Medicare SGR fee-for-service physician payment cut and adopt a long-term plan to replace the formula will cause irreparable harm to physician practices and patients across California.

For a decade, California physicians and organized medicine have been calling upon Congress to eliminate the flawed Medicare SGR and adopt a long-term path to an alternative payment system. While we appreciate the House action in 2010 that repealed the SGR, the Senate did not pass it (despite the positive votes from Senators Feinstein and Boxer). This year, the Senate adopted a short-term patch, but the House did not agree. Each year, physicians and patients are caught up in end-of-the-year political brinksmanship. This year, members of Congress made firm commitments to CMA physicians and seniors that they would stop the cuts and adopt a long-term solution to the failed Medicare SGR physician payment formula. In the height of irresponsibility, Congress has gone home for the holidays and dealt a terrible blow to physician practices and their patients. Most physicians will not be able to sustain such a cut and remain in the Medicare program. Others could be forced to close their doors. Seniors in California are already experiencing difficulty finding physicians. This will have a devastating impact on access to physicians for California’s 5 million seniors and nearly 1 million military families. Moreover, all private health plan payment rates are tied to the Medicare fee schedule, so the negative impact on California patients is widespread.

This inaction is a failure of congressional leadership. All members of the California congressional delegation — both Democrats and Republicans in the House and Senate — agree that the Medicare SGR is an untenable payment system. Yet it remains unresolved. This bipartisan issue is held hostage each year for political purposes. In the past, we could depend on some action, even if belated, to temporarily resolve the Medicare SGR payment cuts. However, we no longer have confidence that the issue will be resolved. California physicians are extremely angry. We have been betrayed and forced to finance the Medicare program on our backs.

Physicians cannot continue to maintain a stable medical practice and plan for the future under the current process. Solo and small-group physicians operate on thin margins and cannot finance these cuts and payment delays. Last time Congress failed to stop the cuts, California oncologists were taking out lines of credit to purchase expensive chemotherapy drugs for their patients. For physicians in certain specialties and geographic regions of the state, Medicare comprises two-thirds of their practice. If this cut remains in effect, patients across California will experience long delays and difficulty finding doctors to care for them. This is not what California physicians want.

Finally, physicians are not just healers. We are employers and important contributors to the California and national economies. Stable Medicare rates help physicians remain in practice, care for patients, and prevent further unemployment and economic erosion.

CMA calls upon you, the leadership of Congress, to resolve this issue immediately. Physicians will be treating patients on Christmas, and we expect you to do your job as stewards of the Medicare program. Thank you for your support.

Sincerely,

James Hay, MD
President

Cc: California Congressional Delegation