Tough new Medicare payment rules . . .

Tougher Medicare Overpayment Rules: What Must You Do Now?

. . . are of keen interest to the medical providers over at the Medscape site.

The answer is, cut your Medicare patient load. Why suffer from the potential for clawback when you can avoid it by simply not treating medicare patients. Who will do this? The better doctors who do have lots of patients lobbying for their time. Or as they say in the business, the best docs! We saw this problem infect the Medicaid ranks, and it will now slowly begin infiltrating the Medicare ranks.

The cure is to eliminate the odd stratified government payment system where Medicaid payments are lowest, Medicare is in the middle, and insurance and private pay at the top.

But everyone want the free lunch, so changing Medicare from the weak system it is today to a better system will be politically difficult or impossible. 

Well, at least until some significant cohort of the Boomers dies out, and the Millennials begin to realize that they are paying for the Boomers and will also have to pay for themselves, plus all the debt the Boomers incurred. Then there will likely be a reckoning, probably a harsh reckoning.