The Doc Fix Is A Leaky Roof?

CRFB received a comment on The Bottom Line the other day, responding to our use of a leaky roof analogy for how health care reform failed to address regular "patches" to prevent scheduled cuts in Medicare payments to physicians. Under current law, Medicare physician payments are set to be cut drastically, ever since lawmakers passed legislation in 1997 to have yearly payment cuts beginning several years later. However, each year Congress has routinely stepped in to prevent these scheduled cuts from actually happening. Here's what we had to say about it:

"It is totally irresponsible to not include fixing this policy as part of health care reform. You don't add a new addition to your home but ignore your leaky roof -- especially when your remodeling costs are being paid for out of your roof-fund. This isn’t a gimmick so much as just being downright irresponsible."

One of our readers disagreed with our analogy, arguing:

"The so-called 'Doc Fix' is much more like a college professor creating a test that no student can realistically pass, then the teacher giving each new semester's student 20% just for signing their name to account for the unrealistic test. I concur that these 'Doc Fix' monies do not show up on future budget projections, but they are not counting on the 'Doc Fix' for any of their deficit reductions."

We agree that the doc fix would have had to be dealt with regardless of whether health reform included it or not, but the problem is that health care reform used up most other health care offsets that could have paid for it.    

In the President's FY2011 budget, the Administration calls for freezing Medicare physician payments at current rates instead of allowing them to fall. CBO estimates that this would cost $286 billion over two years. The health care bill includes some $494 billion cuts to Medicare, which means the doc fix would have consumed over half of health reform's Medicare savings.

This is why we used our leaky roof analogy - it doesn't make any sense to use Medicare savings to pay for new initiatives when these funds could have gone toward "patching" the dox fix - the metaphoric leaky roof in the Medicare "house." We know it's probably not the catchiest analogy, but we continue to be open to other suggestions. Feel free to contribute your analogy in our comments section!