- Cullman, Alabama


December 13, 2012

COMMENTARY: To cut health care costs, pay doctors less


But that shortage is driven by a funding dispute between hospitals and the federal government, over whether Congress should increase subsidies, paid through the Medicare program, for medical residencies. It has nothing to do with people's desire to become doctors: The number of medical-school applicants this year exceeded 45,000, about 35 percent more than a decade ago.

So what's the answer? One option is to cut Medicare rates for specialists, using part of the savings to fund current rates or even gradual increases for primary-care physicians. That would ease some of the pressure on the broader economy, because Medicare rates affect payments by private insurers. It would also change the incentives that drive so many medical students away from family medicine toward more lucrative specialties.

Another option is to replace the current law on Medicare payment rates, which Congress consistently overrides, with legislation that would reduce payments by a smaller amount for all doctors and link them to the rate of economic growth. Congress has failed to stick to this approach before, but if lawmakers believe their own rhetoric about the dangers of rising Medicare costs, this is one way to act on it.

The government could also make an end run around doctors by allowing nurses and physicians' assistants to do more of the work. That possibility alone, which would reduce the role of doctors, and therefore their leverage, should give them an incentive to compromise.

The solutions aren't easy. But the question isn't whether doctors deserve to be paid less. It's whether they deserve a level of protection that's unlikely to be afforded hospitals, nursing homes or Medicare beneficiaries.

Excluding doctors from spending cuts means greater sacrifice from the rest of the health-care world — including their own patients. That's not a picture Norman Rockwell ever painted.

Christopher Flavelle is a health-care policy analyst for Bloomberg Government.

Text Only
  • EDITORIAL: Primary shows maturity, will of voters

    With the local Republican Primary wrapped up, the outcome of three races may have seemed surprising to some observers.

    July 22, 2014

  • COMMENTARY: A break from the campaign rhetoric

    The collective sigh of relief felt throughout Cullman Wednesday morning signaled the end of another primary political season the previous night. As Wednesday’s Times headline told us, it was a clean sweep.

    July 21, 2014

  • Harris Coleman COMMENTARY: Billy Coleman, a true statesman

    King Solomon said, “Pride will ruin people, but those who are humble will be honored.” He also said, “Where there is no vision, the people perish.” Billy Coleman, the past elected superintendent of Cullman County Schools, is the living example of these wise statements of truth.

    July 20, 2014 1 Photo

  • COMMENTARY: Twisty road back to Cullman

    The young journalist who was somewhat listening to the elder newspaperman on the other side of the desk didn’t have a clue.

    July 19, 2014

  • EDITORIAL: Judge makes the right decision

    Many people are closely following the case of Jay Maynor, the man charged with murdering a man convicted of molesting his daughter 12 years ago.

    July 7, 2014

  • EDITORIAL: Truth and independence

    Somewhere along a colonial road between Lexington and Concord, Americans found their courage and resolve to become independent.

    July 4, 2014

  • EDITORIAL: Taking charge with a vote

    The Democratic and Republican primaries arrive Tuesday morning across the state, with many election officials and candidates fearing a low turnout could be in store for what otherwise should be cause for a great gathering of citizens.

    June 3, 2014

  • EDITORIAL: A state dying from drug use

    Alabama coroners, with the power to order and log results of  toxicology reports, hold the key to important information for families and law enforcement officials.

    May 20, 2014

  • EDITORIAL: Looking beyond the standard

    Cullman County schools superintendent Billy Coleman opened a wide door of opportunity when he supported a transition to an appointed executive to lead the local education system.

    May 20, 2014

  • Editorial: Meal money violates trust

    As various local political candidates dash toward the June 3 primary, a troublesome issue remains unattended on the table.

    May 11, 2014