The End of Our Health Care Happy Meal

With the publication in the New York Times of how taxes would be affected because of the Affordable Care Act, our health care Happy Meal was officially pulled from the menu.

Suddenly, the colorful trinkets and tchotchkes that were the first items pulled from the health care law's brightly colored bag are now being followed by a hefty bill that most people aren't too happy with paying: their personal tax bill.

The political backlash was so swift, so sure, that even the White House noticed.
 
So how did the White House respond?

... Treasury Secretary Timothy Geithner has the power to adjust how much is withheld from paychecks for tax purposes — for all taxpayers or just for some.  By doing so, Geithner could ensure paychecks reflect the White House position that wealthier taxpayers with annual income higher than $250,000 see their taxes rise. Geithner at the same time could leave withholding tables where they are for the middle class, ensuring those workers don’t see a higher cut from their paychecks.

But America's doctors should remind the White House why this is not a good idea.  After all, Congress uses this kick-the-can-down-the-road approach with us each time they grant a reprieve to the scheduled physician pay cuts mandated by law as part of the Medicare sustainable growth rate adjustments contained within the Balanced Budget Act of 1997.

Look where this approach has gotten physicians: each year, since 1997, CMS threatens to cut Medicare payments to physicians some 2.5%. Instead of making the cuts each year as directed by law, Congress caved to political pressure and has delayed the cuts year after year.  But the cuts don't go away: they're just added the the following year's paycut amount.  Now the amount has grown to nearly 30% or so with no easy solution in sight.

Imagine what could happen to America's patients if the same approach delay tactic for collecting taxes to pay for our new health care entitlement law is taken.  Can America's health care cost crisis really afford this political approach that ignores reality?

I'm just a doctor, but methinks this idea of leaving withholdings from people's paychecks unchanged is not a good idea just so the White House can dodge a political bullet. 

Since the White House and democratically-controlled Congress helped push our new law through, they should deal with its ramifications responsibly.  To do otherwise is fiscally irresponsible and risks making our horrible health care cost crisis even larger.

-Wes