On the recordJune 24, 2010
I think I should point out when it comes to this issue, there's actually plenty of blame to go around because after all it was in 1988 when a Democratic Congress, voting under the Omnibus Budget Reconciliation Act of 1988, created this problem under the guise of the RVRBS, and it's gone through several names and several acronyms since then. But that's when it began. It was really a very predictable consequence of Congress' interference in the practice of medicine. Since 1988, there have been multiple Congresses; there have been multiple administrations, both Republican and Democratic. The opportunity to fix this thing has been there, but it has not been taken. Patching the payment system is extremely unsatisfactory, but the alternative is absolutely unthinkable. Let me tell you this for a minute what it means in a one- or two-doctor office practicing primary care when the head of CMS holds your paycheck for 1 week, 2 weeks, now 3 weeks. Even if you're doing as little as 15 percent Medicare in your business, that cash flow that's disrupted across the counter means that that doctor's office is likely not going to be able to take a paycheck that month; and what's even worse, they may have to go out and borrow money for operational expenses.
