Medicare’s 4.48% Fee Schedule Cut and Biden’s 4.1% Pay Raise For Federal Employees


In the late 1980s, President Ronald Reagan equipped that, “the nine most terrifying words in the English language are: I’m from the government, and I’m here to help.”

In the late 1970s there was a television detective show, Kojak, whose eponymous main character’s tag line was, “who loves ya, baby?”

And that’s the contrast between the November 1, 2022, announced 4.48% cut in reimbursement to physicians pursuant to Medicare’s 2023 physician fee schedule and President Biden’s announced plan in August 2022 to give civilian federal government workers up to an average 4.6% pay increase for 2023.

I often wonder what these people are thinking, or perhaps not thinking.

In his August announcement, Biden cited recruitment and retention challenges for federal positions as part of the reason for the proposed increases. But one could cut most of the federal government’s civilian employees and hardly anyone would notice. On the other hand, the aging population and their families will notice when physicians no longer accept Medicare.

Neither you nor I can know whether the government’s schizophrenia is part of a great plan to create a healthcare crisis that only “universal healthcare” will resolve, or whether it’s simply incompetence, although it’s probably safer, Occam’s razor style, to assume that they are idiots.

But the takeaway here is that it doesn’t make any difference what the reason is, because, other than through voting and lobbying, none of us, no matter our politics, have any real control over the government’s actions.

But you do have control over what you will do.

Depending upon your medical specialty, you have control over the ability to shift your practice’s business model away from government reimbursement and, in some cases, away from any, or any significant, dependence on third party payors. 

And, in other specialties where facility contracts make that impossible, you have control over business strategy such that you can put yourself in a far better position to obtain stipend support.

But in any event, you can’t wait for the government to help you out, because that help is most likely not coming. They are from the government and they’re not here to help. Ask yourself “who loves ya, baby?” and show some love for your own future.

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