There is a story here somewhere, I have to look at it a bit closer in what Medicare is doing. As you can see expenditures in the US are double or more than what occurs in other countries. Yet, the US life expectancy is less than other countries.

It appears there is a cut which is largely the result of the expiration of a 2.93 percent temporary update to the CF at the end of 2024 and a zero percent baseline update for 2025. This is the current issue doctors are taking to task. The payment is not plummeting. It is not keeping up with the rest of healthcare and costs.

The AMA complains doctor incomes are not keeping up with inflation. There is truth to this and it is also true with others who are not doctors. If doctor incomes are not keeping up with inflation and the US cost of healthcare far exceeds other countries, where are the profits/expenditures of healthcare going?

Various companies making hospital supplies, pharmaceuticals, and other healthcare items appear to be doing quite well. The costs have been a source of various discussions nationally in that people are skimping on taking their medicines, seeing a doctor, etc.

In a FTC report, it was stated a few PBMs dominate the market. Such consolidation results in “increasing vertical integration and consolidation which enables the six largest PBMs to manage nearly 90 percent of all prescriptions filled in the United States. Five of the top six PBMs are now part of corporate healthcare conglomerates that also own and operate some of the nation’s largest health insurance companies, including three of the five largest health insurers in the country.”

But then then the consolidation of PBMs is only one example.

Backed by doctors, the AMA is promoting a revised Medicare payment system which will increase payments to doctors. In the end this will fall back on patients and also Medicare funding as paid by constituents. Four Congressional Representatives who are also doctors are proposing a bill to revise Medicare payment of doctors.

A bipartisan group of lawmakers introduced a bill in Congress to tie the Medicare physician payment schedule to MEI. The AMA-supported bill—H.R. 2474, the Strengthening Medicare for Patients and Providers Act—was introduced by California Democratic Reps. Raul Ruiz, MD, and Ami Bera, MD, along with Republicans Larry Bucshon, MD, of Indiana, and Mariannette Miller-Meeks, MD, of Iowa. The legislative effort could put Congress on the path to finally reforming the outdated Medicare payment system. 

The issue revolves around; The CY 2025 Medicare Conversion Factor (CF) proposal to decrease for the fifth straight year by approximately 2.80 percent from $33.2875 to $32.3562. This cut is largely the result of the expiration of a 2.93 percent temporary update to the CF at the end of 2024 and a zero percent baseline update for 2025 under the Medicare Access and CHIP Reauthorization Act (MACRA). Unfortunately, these cuts coincide with ongoing growth in the cost to practice medicine as CMS projects the increase in the Medicare Economic Index (MEI) for 2025 will be 3.6 percent.

While the AMA is working relentlessly to build understanding on Capitol Hill about the unsustainable path the Medicare payment system is on, preventing further cuts means getting to the root causes of what’s wrong with Medicare physician payment.

AB: The costs of healthcare in the US has been increasing. Perhaps, the increases are not going to doctors; however, healthcare in the US continues to grow more and more expensive. Many patients are skipping meds or healthcare appointments because it is unaffordable even under Medicare or private insurance. What this points out is healthcare costs has become unsustainable for many patients. What the AMA is proposing for doctors is important. No one will deny it. However, the larger picture is many patients can not afford healthcare as it is today and even with some form of healthcare insurance.

The larger picture is a form of Single Payer which I believe doctors would find troublesome also.

AMA fights against Medicare cuts, defending practices & access to care, American Medical Association

Medicare physician pay has plummeted since 2001. Find out why., American Medical Association