Over the weekend someone forwarded an E-mail to me that urged providers to attend a "mock auction" that an economist, Peter Cramton, is holding.
NAIMES has been asking people to go, telling them that it's urgent because "it may be the only chance we have to show that an auction will not work for healthcare. We must be there to share the variables and help Cramton understand the DME industry."
Really?
Cramton isn't going to do this to show that an auction that he favors won't work. He's wanting to do a demonstration of how competitive bidding can work. This mock auction isn't a forum for DME providers to make themselves heard; with all the lobbying that's been done over the last eight-plus years, we've had a ridiculous number of opportunities to say what we've had to say.
There is a difference between not being heard and not being listened to.
Cramton thinks he can show CMS a better way to do bidding. He is not telling CMS that bidding won't work for healthcare. DME providers attending this farce are sending one message and one message only, and that's that the industry supports Cramton's take on bidding.
Readers, if CMS was truly interested in what providers had to say, the agency would've been more responsive to us. Round one has rolled out, and CMS is telling everyone what a great program it is. If CMS is showing interest in Cramton's mock auction, they're doing so not to support a repeal, but to get ideas for future rounds.
One state association leader calls Cramton's work "too important to ignore."
Huh?
Cramton's work is only "important" in that its premise is that the current program won't work as is. And that's where the "importance" of the work ends. Cramton is not our industry's champion; he's out to prove that his version of bidding is better.
Do you support that? I don't. I want competitive bidding repealed, not retooled. The mock auction is not about making ourselves heard, and it's not about making CMS rethink competitive bidding. Industry providers and industry "leaders" can attend this event and make noise when they don't like something, but that's not going to change the focus of the event and it's not going to give us any advantage.
One "leader" said something about the mock auction being an opportunity to have a "discussion."It's not an industry-designed or industry-hosted event. It's an event that people are expected to pay to attend (at $80.00 per person, which no doubt goes into Mr. Cramton's pocket; it's nice of us to line the pockets of a man who wants to teach CMS to build a stronger program) for the privilege of seeing an economist tell CMS how to continue to make it impossible for us to do business.
A discussion? I won't name the "state leader" who came up with that bit of brilliance (this time). But considering how often the individual in question waffles and sucks up to AAHomecare, I guess I'm not surprised. Disappointed, but not surprised. He should be ashamed.
I think that any right-thinking person should boycott this and focus on telling legislators that we are opposed to the continuation of competitive bidding in any form; even that of Peter Cramton.
And I think that any industry "leader" who supports Cramton should be a leader no more.
Speaking of Leaders ...
AAHomecare is doing what it's always done but has never gotten results from.
I've always defined insanity as doing the same thing over and over again but expecting different results.
AAHomecare has persuaded yet another Representative to introduce what's being called a "budget-neutral" bill that will repeal competitive bidding.
Deja vu!!
How many of the past bills to repeal the program have been successful? I can count them on the toes of one hand.
So those of you who are storming D.C. will be able to ask your Representatives to support the bill. And Tyler Wilson is patting himself on the back, expecting the industry to think that he and AAHomecare are the greatest things since sliced bread.
The last bill, introduced by Meek, got 259 supporters, but never got out of committee and never got a single Senator willing to touch it. AAHomecare is saying that people can now go to legislators and talk about the "real" problems with round one: problems with access, confusion, and extra costs because patients can't be discharged as quickly.
Readers, the program was implemented January 1st. We're now in the middle of March. Did anyone honestly expect that implementation of a program so big would have no hiccups? I read about the "problems" in the industry press and from other industry-sympathetic sources, but I have to ask myself this: Are the number of problems increasing? Are they decreasing?
In the long run, competitive bidding will save the Medicare program and beneficiaries money. Lower reimbursements mean lower co-pays, and so seniors aren't shelling out as much if they don't have co-pay coverage.
I don't see how any bill that repeals competitive bidding can begin to be "budget-neutral," and fully expect that the score the legislation will receive will show that my skepticism is right, unless the intent is to slash reimbursements as the pay-for. I don't know about you, but my rising costs of doing business don't allow me to continue to do business by making less money.
I won't need competitive bidding in my area to put me out of business if the already-low reimbursements are cut even more. That's the harsh reality of DME, and people who have no experience running a DME (I'm talking to you, Tyler Wilson) shouldn't be making promises and deals on my behalf that I'm very sure I can't afford. People who answer to boards ruled by big companies with far deeper pockets than I have just don't have a firm grip on the difficulties of running a small industry business, and I'm not interested in following those types (I'm still talking to you, Tyler Wilson).
Do I want to see competitive bidding repealed? Yes. Do I think that AAHomecare's latest attempt at a bill will succeed? No. AAHomecare has handed the industry failure after failure, and I don't see that they've done anything new that's going to change the association's losing streak. I think they're ineffective, and history bears out my judgment.
Too Many Problems and No Solutions
AAHomecare isn't the answer; Peter Cramton and his "mock auction" isn't the answer. I'm going to try to ignore Tyler Wilson and his "go me" posturing; I recognize a bunch of hot air when I hear it.
I'm absolutely boycotting Cramton's event, because I don't want my presence to be construed as supporting a revised method of bidding that might actually work.
I want to serve my patients and earn an honest living. I know that I have to be involved to get rid of competitive bidding, but I'm not interested in doing the same things over and over again and expecting different results. I don't know what the solution is, but I know what -- and who -- hasn't worked, and I don't think it's unreasonable of me to think what I do.
What troubles me are the people who will believe in yet another bill and who will believe that they're going to "be heard" at Cramton's event, and that things will change as a result.
I don't like being let down, and so I choose to travel the road of realism. I don't put my faith in false prophets.
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