Buyer’s remorse for H.R. 2 – MACRA, SGR “Fix”

Dr. Chip writes in:

The two lines in the entire argument made in this article“The repeal of the SGR is the carrot; the far-reaching payment reforms that the legislation facilitates are the stick,” is the basis of the discussion we wanted to initiate nearly 4 years ago both at the house of delegates and in discussion through our own Publications in “Saving Private Osteopathic Medicine.” All our journals refused to publish our position for an invitation to have a discussion in a public forum AND NOT BEHIND CLOSED DOORS. Promises were made and never kept. Tyranny reins under circumstances like these.

The net result is that concerns of the people in the trenches (Doctors and Patients) never got a fair hearing or opportunity for open discussion and the evidence is now before us in several bills that the AOA has supported which continue to squelch independent thinking, independent judgement and independent practice. This is and has been supporting ever increasing expenditures on bureaucratic processes and infrastructure that lends little to nothing, to the actual delivery of care and more so hamstrings the deliverers of care to protocols and limits that deny individualized care routinely.

“Physicians who supported this new law risk buyer’s remorse when they realize that underneath the 11 pages repealing the SGR lies 200 more pages of bureaucratic and regulatory control over how medical care is paid for, delivered, reported, and measured for quality. After all that – how much decision making is left?

If the price of repealing the SGR is a doctor’s freedom to practice medicine according to his own skill and judgment – it’s a price too high to pay.”

If the leaders of the profession cannot see this at this point after actually reading the 200+ page document of MACRA and they are not alarmed by the wide celebration of the congress and senate about this bill and its successful passing then our leaders are indeed blind to the clearest fact we have always wanted to discuss with transparency. If we follow the dollar in this thought process we are left with an inescapable truth, the profession of healthcare delivery is being corporatized for the financial benefit of very few and at the expense of the populations access to proper healthcare with the fees coming from their tax dollars and from their premiums.

Charles J Smutny III, DO, FAAO

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