Dr. Kristin Story Held
The Government Takeover of Medicine
When Medicare and Medicaid were created, the government promised not to interfere in the practice of medicine in any way. President Lyndon Johnson signed the Act into law on July 30, 1965, ironically in Independence, MO.
It read: Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer, or employee, or any institution, agency or person providing health care services… or to exercise any supervision or control over the administration or operation of any such [health-care] institution, agency, or person. Section 1801, Medicare Act, 1965
Fifty years later, in flagrant violation of this prohibition clause, stands the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), replete with the Merit-Based Incentive Payment System (MIPS). MIPS is a rubric the federal government uses to grade physicians and assign each a score of 0 to 100. The Composite Performance Score (CPS) is used to financially incentivize or penalize physicians, and then the scores are posted on a public website for all to see.
The core of MIPS is the ultimate conflict of interest: the very lives and well-being of America’s patients vs. the money and power of the medico-industrial complex run by a small group of insider elites, implemented and micro managed by entrenched, faceless deep state bureaucrats. Physicians must choose sides.
Will your physician follow the tradition of Hippocrates, who believed the physician works on behalf of the patient, not for the good of the state—risking his livelihood? Or will he follow the Greek philosopher Plato, who urged that doctors refrain from curing the weak and infirm to improve society? MIPS incentives mean punishment and abuse for serving patients first, and rewards for serving society.
MIPS grades physicians on quality (outcomes), advancing care information, improvement activities, and cost. Earning a high score often requires doing what government says instead of what is best for the patient.
Kristin Story Held, M.D. is a board certified ophthalmologist and ophthalmic surgeon. She is a Phi Beta Kappa Graduate from the University of Texas at Austin and received her medical degree from the University of Texas Medical School at San Antonio where she was elected to AOA. Following her internship in internal medicine and residency in ophthalmology, Dr. Held joined the faculty at the Univ. of TX Health Science Center at San Antonio where she taught residents and medical students and served as Director of the County Ophthalmology Clinic. She maintains an academic affiliation as a Clinical Professor in the Department of Ophthalmology. For the past 20 years she has been in private practice in San Antonio.
Dr. Kristin Held M.D. and the amazing details on what the USG has in mind for Health Care, December 14