David B. Hoyt, MD, FACS, is the executive director of the American College of Surgeons. The opinions expressed in this commentary are his own.

Perspectives David B Hoyt

The Covid-19 pandemic has thus far killed more than 170,000 Americans and infected more than 5.2 million. The country’s doctors and health care workers have been on the frontlines for the past six months, often working longer hours without any added pay, sleep or complaint to meet the overwhelming demands of this outbreak. Our health care system has suffered greatly due to Covid-19, and now surgeons could be faced with ill-advised and dangerous pay cuts.

The Centers for Medicare & Medicaid Services (CMS) recently proposed that, beginning January 1, payments for surgeons seeing Medicare patients be cut, declining, for instance, by 9% for cardiac surgery, 8% for thoracic surgery and 7% for vascular surgery. The law currently mandates any CMS changes to be budget neutral, so the cuts are required in order to increase spending in other places, such as telehealth. But telehealth is no replacement for surgical care, and the health care system simply cannot absorb cuts of this magnitude right now. The public comment period for the change is open through October, but it will likely require Congress to step in to prevent these devastating cuts from taking effect. The impact of Covid-19 on both surgical practices and their patients has been devastating. Months-long bans on non-emergency but medically necessary surgeries led to worsening outcomes, as conditions that could have been treated with a minor intervention instead caused disability or even death. Meanwhile, one in three private surgical practices are at risk of closing permanently due to the financial impact of Covid-19, according to a recent nationwide survey. These additional Medicare cuts will force more surgeons to close their practices, reducing patients’ timely access to quality care.MIT researchers created a reusable face mask that works like an N95 respiratorMIT researchers created a reusable face mask that works like an N95 respiratorMIT researchers created a reusable face mask that works like an N95 respiratorAmerica’s surgical care system was already facing significant structural challenges. Surgeons contend with high fixed costs and debt, and now face plummeting revenue. Over the last 20 years, the costs of being a surgeon have increased while Medicare’s surgical payments have not only failed to keep up with inflation but have actually declined in nominal terms. It costs more to operate a surgical practice, but Medicare is paying less.The new rules from CMS reduce the Medicare conversion factor, the basic starting point for unit cost calculations for medical care, by nearly 11%, bringing it to its lowest point in 25 years. What’s worse is that private insurance often bases how much it pays surgeons on Medicare’s rates, meaning these cuts will be compounded throughout the health care system. Read MoreCongress needs to enact legislation to waive Medicare’s budget neutrality requirements so that these cuts are not necessary. Our medical system needs all the help that it can get right now.This is not the time to make any cuts to Medicare as the country deals with the worst health care crisis in a generation. Our doctors and health care workers have been there for the American people during this pandemic. Now doctors need Congress to help them.

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