The ACC partnered with hospitals (AHA), insurers (AHIP), AARP, AMA and others on a study on the impacts of the various proposals out there to cap Medicare premiums and/or propose across-the-board Medicare and Medicaid spending cuts. These proposals do not fairly estimate the downstream impacts that will occur to everyday citizens and to health care. We selected the Lewin Group (I can obviously get a family discount there). The study was released to members of Congress and the public. It’s a necessary part of this necessary discussion on how to reduce the national deficit. But let’s do it with eyes wide open and with an objective understanding of the impacts of various proposals -- and new ones pop up every day.

A call for across-the-board spending cuts is imminent. We asked the The Lewin Group to specifically examine the Commitment to American Prosperity (CAP) Act -- since it passed the House -- even though we recognize that deficit reduction is a process, and that the CAP Act is unlikely to be the final piece of legislation brought to a vote. We think similar consequences would result from any across-the-board measure that limits spending. Recognizing and supporting the need for deficit reduction for the nation’s well being, the report calls for payment reform and other approaches. We think this is the right approach.

President Obama and VP Joe Biden and Senate Minority Leader Mitch McConnell (R-Ky.) are now trying to wrestle out a plan before the debt ceiling default hits in another month. If there are no additional revenues proposed, the Lewin Group projected that the CAP act or similar across the board cuts would produce:

• Cuts by nearly 20 percent over ten years to Social Security benefits;
• Cuts to Social Security and other income support programs that would force 3.8 million people into poverty -- 2.1 million of them seniors, a 45% increase;
• Lost health insurance for 5.1 million individuals;
• Cuts to hospitals that could force most to operate in the red, jeopardizing access to care;
• Dramatic reductions in fees for physicians that would lead to fewer physicians participating in Medicare;
• Lost jobs for up to 1.3 million health care workers; and
• A nearly 5% increase in health insurance premiums due to cost-shifting of federal payment shortfalls to private employers.

The message to Congress should not be to avoid making cuts to balance the budget and eliminate the deficit over the next decade or so. That needs to happen. But, without additional revenues, the consequences to medicine, patients, and health care will much more grim than anyone’s talking about.

More coverage: "Doc Groups Get Figures on Feds' Spending Cut Plans," MedPage Today

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