Congress’ leadership needed to stabilize an overwhelmed patient care system

During my shift today as a Hospitalist at a Central Coast California hospital, I heard my second “Code ED” overhead alert in less than five hours. “Code ED” means the doctors and nurses in the emergency room need assistance from other areas of the hospital to help care for patients. Before the pandemic it was rare to ever hear that code, and I had never heard it twice in the same day. Today, as our hospitals are at or beyond capacity, and nurses and doctors are out sick themselves, a crisis of grave proportions is taking shape and we hear the code often. 

Across the state, our health care systems are stretched to the limit with the current surge of respiratory syncytial virus (RSV), influenza and COVID-19. Hospitals are breaking volume records, with health care workers and systems struggling to keep up with demand. While this surge is far less fatal than the crisis of the last 34 months, it nevertheless requires the expenditure of precious medical resources from very fatigued health care professionals. For us and the patients we serve, the crisis is far from over.  

As we attempt to steer the still teetering health system away from the edge of collapse, we are facing an 8.5 percent cut to Medicare physician payments next year unless Congress acts soon.   

I can’t think of a worse time to enact cuts to Medicare.  

America’s health care system needs more stability, not less. In a recent CMA survey, 76 percent of physicians reported that Medicare payments no longer cover their costs to provide care, and it is causing many physicians to seriously consider whether they can continue accepting new patients, leave Medicare or retire early. As communities grapple with provider shortages, we must ensure that enough physicians remain to meet the growing demands that aging seniors and public health pandemics are imposing on our resources.   

Physicians are already fighting an uphill battle, because while hospital and nursing home payments are indexed to inflation (and as a result have increased by 60 percent since 2001), the broken physician payment system has required fighting cuts year after year.  

Health care providers throughout the country are calling on Congress to support HR 8800, the “Supporting Medicare Providers Act,” before the close of the congressional session. The bipartisan legislation was introduced by Reps. Ami Bera, MD, a California Democrat, and Larry Bucshon, MD, an Indiana Republican and has 72 co-sponsors. The bill recognizes that Medicare patients deserve the highest quality care.   

During this holiday season, I feel very grateful to have a life dedicated to both service and science. I think I can say, in speaking for my fellow physicians, we do this not only because we’ve been trained to, but because we love caring for patients, all of whom are our neighbors and members of our communities. Now, physicians, patients and communities need Congress’ leadership to stabilize and sustain an overwhelmed and fragile patient care system. We urge Congress to pass HR 8800 to stabilize our practices and address our safety nets that are teetering on the edge of collapse. 

Donaldo M. Hernandez MD, FACP, is the president of the California Medical Association. He is an Internist.