Focus on Medicare payment reform, not pay-for-performance proposal

LETTER — Posted Sept. 26, 2005

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Regarding "Panel sets primary care standards for Medicare pay-for-performance" (Article, Sept. 5): Pay-for-performance versus a fix of the Medicare system (with its fatally flawed SGR conversion). Hmmmm. That one's a no-brainer.

Let's remember back to when Medicare started. Our own past president, Edward Annis, MD, sat at the table and fought nobly for all physicians. In the end, we were force-fed Medicare, which has become the government-run agency that we were promised it would not become.

Recently Medicare reimbursement has declined to the point that many physicians seek out other financial opportunities outside of the practice of medicine, leaving patients few seasoned physicians.

For the 2% swing that pay-for-performance is reporting, I place all of my chips on fixing the Medicare system and the way by which physicians are reimbursed.

Pay-for-performance should be placed behind the Medicare repairs and not supersede them. If we, as members of the AMA, allow this to happen, then we are all going to be worse off than we are now. Fight for Medicare reimbursement reform now.

Corey L Howard, MD, Naples, Fla.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/09/26/edlt0926.htm.

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