Policy Solutions to the Border Crisis

Floor Speech

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Mr. MURPHY. Mr. Speaker, I rise today in opposition to the CMS' proposed Medicare cut of 3.37 percent.

Just to put this in perspective, when a physician sees a Medicare patient, they do it because they care about patients. They do not do it for money, because it doesn't make financial sense.

Let me give an example here.

You own a hardware store and you want to sell hammers. It costs you $1 for each hammer. Say, the hammer is on Medicare, or you have to buy the Medicare, and you have to sell it for 60 cents.

How long do you stay in business? It doesn't make sense.

So as we move time and time and time again, the number of physicians who are able to take Medicare patients, out of the goodness of their heart, is falling and falling. You actually lose money on Medicare or Medicare patients that has to be taken up through cost shifting for regular insurance.

When I ran a private practice, I stayed up many, many nights, Saturday nights, searching for paper clips, making sure that I knew where every penny went. I just had to make sure that my staff and the bills got paid before I ever got paid.

My practice was heavily Medicare, so I did not take a salary many, many times because the numbers did not work. In fact, adjusted for overinflation for the last 20 years, Medicare physician fee schedules have dropped 20 percent, and this is in light of the massive inflation we have had over the last 2 years; even worse.

Mr. Speaker, what other profession expects to get a pay cut every year?

This has to stop.

These are the people who are actually up in the middle of the night taking care of your grandmother who has appendicitis, taking care of your daughter, taking care of your child with a broken arm. They are the ones doing this, and here we are rewarding them because they basically have to take government pay patients by cutting and cutting and cutting.

One of ObamaCare's directives was to starve private practices to force physicians to work in hospitals or big conglomerations.

How did they do this? They cut their pay every year while hospitals, although not as much so, got raises every year.

So what does this do? It pushes physicians out of private practice because they can't pay the bills.

Mr. Speaker, I left my private practice when my partner said: We can't do this anymore. We are going to be acquired by a hospital.

Mr. MURPHY: We can't provide the care to the patients that they need.

Why is it a bad model? Private-practice physicians are different birds than employed physicians. It is just very simple. It is a well- known fact in medicine. Those employed physicians tend to be less efficient, cost more, and tend to work more on the clock.

Those who are in private practice put a taproot down in a community. They have stayed there, and they are someone's doctor for 20, 30 years or more. This is not happening now. They have made transitory medicine the rule, not the exception.

The cuts that are going to the Medicare fee schedule absolutely need to stop. This is why I introduced H.R. 6683, the Preserving Seniors' Access to Physicians Act.

This legislation will stop this year's cuts while we work on a permanent solution. This is not something that needs to happen year after year after year where we are cutting and cutting the people who actually take care of patients.

Mr. Speaker, I came to Congress to help work with my colleagues to help fix Medicare. We are facing an absolute calamity with the shortage of doctors, especially surgeons, in the next 3 to 5 years. Those who are reaching retirement age, instead of working like most physicians do, are finally throwing up their hands and saying, we are done.

Sadly enough, the ones coming out of medical school now--because of some of the processes now were not working hard enough--are not nearly coming out in the numbers and the efficiency to take the place of those retiring.

Every day, we now add 10,000 new patients to the Medicare rolls. You are expecting doctors to continue to take more and more Medicare, earning less and less and less. They are going to go out of business or have to go into employment, which we all know is a worse way of taking care of patients.

Mr. Speaker, I ask my colleagues to support H.R. 6683 and help us try to keep medicine back on track.

Thank you.

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