Friday, December 21, 2012

The Fiscal Cliff is Coming to Town

If you had to describe the current state of affairs in Washington, which of the following famous quotes would you use?

Ronald Reagan: “There they [he] goes again”

Yogi Berra: “Déjà vu all Over Again” or

Mark Twain:  “Suppose you were an idiot. And suppose you were a member of Congress. But I repeat myself.” 

How about all of the above?   Congress once again is going home for the holidays, without agreeing on a bill to prevent massive cuts in Medicare payments to physicians.  We went through this last year—but this time is different, and worse.  The physician payment cut is steeper—nearly 30%.   The impasse is not only on Medicare payments, but hundreds of billions of dollars of across the board “sequestration” cuts in federal programs and tax cuts that are set to expire on the first of the year.

The latest non-development was when Speaker Boehner found last night he didn’t have enough votes in his own GOP caucus to pass his “Plan B” (renewing tax cuts for people who earn less than a million dollars—nothing about stopping the Medicare SGR cut), greatly weakening his leverage in any renewed negotiations with President Obama, should they occur.  The Senate will recess today.  This will leave Congress with only 6 days at most—yes, SIX days—to reach an agreement with President Obama after it returns to Washington on December 26. 

Sure, a Christmas miracle could happen, but I wouldn’t bet on it.  Right now, it looks more likely that the impasse will not be resolved until after that automatic cuts and tax increases go into effect on January 1.  Yes, that means physicians should plan for the likelihood that the Medicare physician payment cut will happen, and may not be reversed for several weeks. ACP members can keep up the latest news about how the cut will affect them and what they can do to prepare at ACP’s Running Your Practice resource page.  And please keep the up the pressure on your own members of Congress.

Eventually, there will be a deal.   Once the physician payment cut happens, and Medicare patients can’t find doctors, and taxes go up on just about everyone, and agencies have to start laying off the federal employees who keep our food and drugs safe, and the Pentagon’s ability to defend our country is weakened, a deal will be reached.  But a lot of folks will be hurt in the meantime.

ACP is doing everything it can to get Congress and the President to reach an agreement to stop the cuts and enact a fiscally responsible alternative, offering them this week our own three-step plan to eliminate the SGR by the end of next year.  Last week, incoming Board of Regents chair, Chuck Cutler, MD, FACP, traveled to Capitol Hill to lobby Congress with his counterparts at the AMA, American Academy of Family Physicians, American College of Surgeons, and American Osteopathic Association. 

I know the situation isn’t funny. But this is the time of year that is supposed to be joyous, and I have a tradition of having my last post before Christmas being a humorous (I hope) adaption of a Christmas Classic to reflect the latest in Washington. So here’s my latest, sang to the tune of Santa Claus is Coming to Town:

The Fiscal Cliff Is Comin' To Town"

You better watch out
You’ll want to cry
You’ll want to pout
I'm telling you why
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town

Congress is making a list,
Checking it twice;
Gonna cut programs, it ain’t gonna be nice.
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town

It will cut your pay while you're sleeping
It will raise your taxes when awake
It will cut programs, both bad and  good
Even Medicare, for goodness sake!
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town

You better watch out
You’ll want to cry
You’ll want to pout
I'm telling you why
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town

The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town
The Fiscal Cliff is coming to town

The Fiscal Cliff is coming
The Fiscal Cliff is coming to town

(Coming to town)
Congress is a busy place, they have no time to play
But they’re putting coal in your stocking this Christmas day
(The Fiscal Cliff is coming to town)
(Coming to town)
(The Fiscal Cliff is coming to town)
(Coming to town)!

Today’s question: No question today, just my best wishes to you and your loved ones for a peaceful holiday, notwithstanding the mess Washington has created.

1 comment :

ryanjo said...

"Suppose you were an idiot. And suppose you were a member of Congress. But I repeat myself.”
― Mark Twain