Is your doctor going to be forced out of Medicare?

You've probably been watching the ongoing dustup in Washington concerning the continuation of the payroll tax cuts. Maybe you've been thinking "Thank goodness it doesn't affect me since I no longer receive a paycheck." Boy, are you wrong!

Included with this bill is a two-month extension of the Medicare "Doc Fix." The "Doc Fix" is a yearly ritual in Congress "...required by a 1990s budget law that failed to control spending but never got repealed. Instead, Congress passes a temporary fix each time, only to grow the size of cuts required next time around." This according to a piece in today's Huffington Post.

If the "Doc Fix" is not passed, Medicare payment to doctors will decrease by 27.4% as of January 1. (Medicare says that it will withhold payments to doctors for the first 10 business days of 2012 in hopes that the "Doc Fix" can be put into place. According to Medicare, any backup beyond 10 days is not possible without crashing its computer systems.)

If you have moved recently, you may have encountered difficulty finding a new doctor. Medicare payments are not lavish, and some doctors have simply refused to see new Medicare patients. If payments decrease by almost 30%, many more doctors are likely to opt out of Medicare.

Almost everyone expects the "Doc Fix" to eventually pass, so why is this happening? It mostly has to do with the inability of Congress to vote on things separately. Instead, they combine something that one side wants into a bill with something they don't want in hopes of using the "want" as leverage.

The current situation is also an example of poor negotiating practices. According to Ezra Klein in today's Washington Post: "Remember what everyone thought was happening here: Mitch McConnell was negotiating with Harry Reid on behalf of Senate and House Republicans. Those negotiations were successful. Almost every Senate Republican voted for the resulting bill. Boehner went to sell that bill to his members. But then the House Republicans rejected it, and we were back at square one."

Everyone who has ever served as a negotiator for their union understands one of the basic rules of negotiating: Don't send someone to the table unless they have the authority to make a deal.