Urologist with focus on BPH / HoLEP. Strongly opposed to killing patients
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It’s going to your local hospital/health system C-Suite.
It’s going to private jets, stadium suites, retreats, and the most ridiculous advertising known to man.
It’s going to the local bankers (typically on your local not-for-profit hospital/health system board).
It’s going to the local/regional architects and general contractors (typically on your local not-for-profit hospital/health system board).
It’s going to attorneys, consultants, and accountants (also typically on your local not-for-profit hospital/health system board).
What’s left over goes to Blackrock, State Street, and Vanguard as assets under management.
For all you health policy idiots. See below
Premiums double, but reimbursements to doctors are basically flat. Stop blaming us. Where is that money going? Cause it’s not going to doctors!!!
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El Sayed doesn’t want to work with the Middle Eastern countries who have outlawed the Muslim Brotherhood, go figure.
"I would like us to figure out how to stop making deals with countries like Saudi Arabia or the UAE, who are doing genocide in Sudan. I would like us to actually promote our values." Gulf state allies are going to feel the difference with the new Congress.
Community note
المنشور مضلل وغير صحيح؛ تقود السعودية وساطة عبر "منبر جدة" لحماية مدنيي السودان وإغاثتهم وحث الأطراف على الالتزام بالقانون الدولي الإنساني. بالمقابل، تشير تقارير خبراء الأمم المتحدة والخارجية الأمريكية لوجود أدلة على دعم الإمارات لقوات الدعم السريع ومرتزقة أجانب.
spa.gov.sa/en/N2622458
bloomberg.com/news/articles/…
spa.gov.sa/en/N2635176
spa.gov.sa/w190059
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Physician reimbursement down 12% while..
Healthcare insurance premiums up 146%
Admin roles up 156%
Make sense?
If you think doctors are the problem when it comes to healthcare costs…check this:
Physician reimbursement ($/RVU) is DOWN 12%
Meanwhile…
Health insurance premiums are UP 146%
Inflation is UP 65%
Medical school debt is UP 72%
Healthcare administrator roles are UP 156%
The math is not mathing🤨
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This is sectarian politics. Americans should start to understand it.
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If you think doctors are the problem when it comes to healthcare costs…check this:
Physician reimbursement ($/RVU) is DOWN 12%
Meanwhile…
Health insurance premiums are UP 146%
Inflation is UP 65%
Medical school debt is UP 72%
Healthcare administrator roles are UP 156%
The math is not mathing🤨
It's annual paycut season for doctors, brought to us by @CMSGov…
And, drumroll…it's a cut. Again.
-2.31% for most of the house of medicine in 2027 on the RVU conversion factor (to $32.63/RVU).
Adjusted for inflation, that's:
A one-year 4.7% decrease,
A 10-year cut of 32.6%,
A 20-year cut of 46%.
Yikes.
Thanks, @RobertKennedyJr.
😬😬😬
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I see so many posts about how US physicians are making more than physicians elsewhere in the world. This shows the lack of insight by so many.
U.S. doctors out-earn foreign peers? So do U.S. lawyers (+112%), software developers (+81%) and architects (+60%) vs. UK peers. Higher U.S. pay ≠ overpayment. Yet Medicare physician rates have fallen 33% after practice-cost inflation since 2001. That’s a threat to patient access.
The issue at hand is patient care and erosion of the system that allows us to tend to the health needs of our population.
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Dudes, ignorance hurts my chest.
He lectures independent physicians about being selfish while ignoring the facility fees and institutional subsidies supporting his own health system. UCLA charges facility fees in addition to physician fees and receives supplemental government funding.
For some outpatient services, patients and insurers pay more than four times as much in hospital clinics as in independent offices. Yet independent physicians asking for payments that cover their overhead are supposedly the problem.
Dude, at least understand the issue before spouting BS….
What entitled ivory tower bullshit
US physicians are the highest paid physicians in the world by the way and top 2% income in the country so when you cry about CMS cuts youre revealing what a privileged out of touch selfish jack ass you are
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El-Sayed , first author paper :
“It is plausible that Arab cultural traditions, specifically the paucity of a culture of explicit exercise, as well as a more corpulent image of beauty, may promote chronic disease risk factors, and ultimately mortality among this group relative to Whites”
I would not be talking about my H-index if I had written that.
I've been in politics for a quarter century. It's hard to express how staggering it is to see a conversation like this on corporate US media. The Morning Joe panel gobsmacked by the directness of @AbdulElSayed's points.
(clip via @DropSiteNews)
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It's annual paycut season for doctors, brought to us by @CMSGov…
And, drumroll…it's a cut. Again.
-2.31% for most of the house of medicine in 2027 on the RVU conversion factor (to $32.63/RVU).
Adjusted for inflation, that's:
A one-year 4.7% decrease,
A 10-year cut of 32.6%,
A 20-year cut of 46%.
Yikes.
Thanks, @RobertKennedyJr.
😬😬😬
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Sells out to PE( utterly disgraceful) for big bucks,has a passive income stream to boot, then has the audacity to say “I’ve been overpaid my whole career.” WOW!!!
I retired two years ago and over my 26+ years as a PP Orthopaedic Surgeon, MC systematically reduced/ slashed /cut my reimbursements 34%!! Now, they’re about to gash my colleagues another 13% for TKA’s & THA’s.
I would love for our PCP’s to make more, but to think or suggest cutting highly trained specialists fees is the answer is assinine. We as physicians, collectively, need more help not less.
Sorry, but not actually, your take on all of this is pathetic and embarrassing.
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Physician services is the only thing that the US government pays below market prices for. Doing our part to help balance the budget.
Year after year the AMA asks you to join to support their efforts to protect physician reimbursement.
It's not working.
How much pressure can they apply when their survival depends on CMS continuing to require CPT - their main source of revenue- for physician billing?
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There's plenty to dislike about insurance companies. But they are not responsible for high insurance premiums. Attacking them just shows economic illiteracy.
Look at @zackcooperYale's work out of Yale. Insurance premiums directly track with healthcare spending.
Want lower insurance premiums? Remove the incentives for large healthcare systems to consolidate and raise prices. That's the #1 driver of your high insurance premiums.
Also contributing: you're being forced to buy a package of services you don't necessarily need. The "essential benefits" include things that most Americans would probably forego if given the choice, especially if it were to drive down their price.
It would be like if the government mandated that auto insurance cover oil changes, tire rotations, and a tank of gas twice a month. Auto insurance premiums would be sky high.
If we are going to have rational conversations about healthcare reform, we have to move beyond the simplistic "insurance companies are bad" pandering.
Key word from headline: enraging.
This is fantastic reporting on the dramatic surge in premiums facing ACA enrollees.
Democrats need to wake up and 1) attack the insurers and 2) articulate a serious plan for a rational universal health care system.
seattletimes.com/business/en…
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CMS just finalized the 2027 Medicare conversion factor at $32.63, a 2.31% cut from this year. In 2001 the conversion factor was $38.26, which is worth about $70 in today's dollars, so Medicare now pays a little less than half of what it paid for the same work 25 years ago. Most of this year's cut is simply the expiration of a one time increase Congress added for 2026.
I am starting a brand new interventional pain practice in July 2027, and numbers like this make me less inclined to want to take Medicare. At the same time, I want to get myself out there in the community as much as possible and take care of the people who need it, and the people who need interventional pain care the most are Medicare patients.
That is the tension independent practices are now being forced to operate under. This is neither a win for independent practices nor patients.
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In hindsight, it was a mistake for SpaceX to send them thousands of free Starlink dishes and millions of dollars a month in free service at the beginning of the war.
What started as internet access for civilians became the backbone for autonomous killing drones. And now if they don’t support military use, they get skewered for it in the press.
Ukrainian President Zelensky on Elon Musk:
"Having so much power concentrated in the hands of a very rich person is dangerous.
Concentrating power in the hands of one person who doesn't have much money is also dangerous.
That is the whole point of the separation of powers: making sure that everything is not concentrated in the hands of one person."
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It is Medicare For All. Just click on the link
The question is why folks like @ajlamesa are trying to confuse the public with “universal health plan” language.
All of these plans will functionally outlaw private insurance and force providers to accept Medicare rates.
Mental health/1º care gets a 30% bump in rates, but if you think that will last, may I introduce you to the Medicare conversion factor.
No. It's not. Among other things, Medicare for All is a single payer system.
Give your preferred policy a different name instead of trying to confuse people and ride the coattails of the better policy.
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Medicare keeps cutting physician rates while our costs keep going up. That disregard for physicians is why many physicians have lost trust in the system.
For 2027, the conversion factor for most physicians drops 2.31%. That’s six cuts in seven years. Hospital outpatient rates go up 2.3%. A hospital can also bill a facility fee for the same visit I provide in my office, and my patient can owe more.
The annual share of physicians who stopped billing traditional Medicare doubled from 2010 to 2023. Physicians also say they plan to retire earlier.
Politicians and people like @ajlamesa want to expand Medicare. I’d like them to explain who’s going to see the additional patients at the rates Medicare pays.
And physician payments under the PFS have been cut 6 out of the last 7 years. The PFS needs to be reformed!
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Biz-splaining the running of a practice to me, and dismissing the overhead and regulatory headaches I deal with daily, is humorous….
First, CBO says your wrong… and
history shows your wrong….
From 2001 to 2026, Medicare
physician payments rose roughly 10% while practice costs rose 63%. CBO’s illustrative single payer scenarios modeled physician fees in 2030 at roughly projected current law averages or 7% below them, depending on the scenario.
Second, there is no established fee…
It is all determined by CMS regulators
H.R. 3069 leaves the actual fee schedule to be developed.
Third, prior auth and MIPS are a small part of the overall overhead and compliance costs have risen independent of prior authorization…
Yes, Eliminating prior authorization and MIPS would reduce costs. Whether those savings outweigh any payment reductions depends on the actual rates and remaining overhead.
I have years of experience paying for regulatory failures. You’re asking me to assume the same regulatory system will deliver better practice economics before those numbers exist, then treating my skepticism as ignorance.
You keep claiming M4A will squeeze physician pay and increase administrative burdens. Based on what? Today's Medicare? Hr 3069 is a different payment system.
Let's look at what the bill actually does: it eliminates prior authorization and step therapy for covered care. Establishes uniform national billing and a NEW physician fee schedule with physician input and regional review boards. Eliminates MIPS and specified pay-for-performance programs. Replaces hospital fee-for-service billing with global budgets.Preserves private contracting for physicians who opt out.
Doctors operate businesses. What matters isn't just reimbursement per procedure. It's collections minus expenses. Eliminate much of the insurance bureaucracy and physicians could earn MORE while spending LESS time fighting insurers.
I agree physician compensation needs safeguards. But where's your analysis of the administrative savings, practice profitability, and increased patient access?
You can't ignore everything the legislation eliminates, assume everything gets worse, and call that an economic argument. That's criticizing today's Medicare and pretending you've disproved its proposed replacement.
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The political left sees physicians as serfs.
Proof:
Dr. Marshall probably saw tens of thousands of patients over his career and @nytimes ran a political hit before midterms because his practice submitted 700 unpaid bills on his behalf to a collection agency.
I hope Kansas voters won’t reelect the Republican who’s fine with suing and jailing women for the “crime” of accessing health care.
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