MACRA/MIPS is the problem, individual health freedom is the answer
Dear Congress & CMS,
The original stated goal of Medicare in 1965, to give healthcare to those at the end of life—when life expectancy was about 65 years—was credible and laudable. However forcing all citizens to participate in Medicare, and pay hard-earned dollars into a system that they don’t want to use is not laudable, especially given the expanding government interference in Medicare which exponentially increases under MACRA/MIPS.
The original 18-page legislation declared:
"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...."
Since 1965 every act of Congress and all CMS rules for Medicare have violated the original Medicare law. The latest iteration, MACRA/MIPS, is the last straw and breaks the camel's back of Medicare.
It usurps all Medicare patient privacy by giving CMS, insurance companies, contractors and their designees unfettered access to all demographic and health data. This is a violation of the patient/physician relationship and nullifies any claimed health benefit effects. Further, it subjugates physicians to “composite scores” based on arbitrary statistical calculations that have no bearing or merit for the individual patient.
further reading: 7 things physicians need to know about MACRA proposed rule
Furthermore, even before the associated penalties are factored in, it is impossible for a solo- or small-practice physician to comply with the onerous financial costs to implement this data gathering and sharing.
Finally, MACRA/MIPS does nothing to improve the health of groups or individuals as initially intended, but only increases the cost of care, decreases its efficiency, and further takes the right to choose away from the patient.