Medicare payments to doctors will fall by 21 percent starting on Monday, but Congress may soon act to block the cut. It’s the latest reminder of a chronic problem for the federal government: figuring out how to pay doctors who treat Medicare patients.
The story goes all the way back to 1965, when the federal government was about to launch Medicare ”” the health-insurance plan for the elderly.
The idea of a government-run health-insurance plan made doctors nervous, and Lyndon Johnson’s administration was worried that doctors wouldn’t take Medicare patients. So Joseph Califano, Johnson’s adviser for domestic affairs, made what seemed like a small concession: Medicare would pay doctors whatever they thought was reasonable.
That worked out well for doctors. They had been providing lots of free care for old people, and they started getting paid whatever they asked for, as long as it wasn’t wildly out of line with what others were charging….