NOWhile ?just say no? is a popular political slogan and now even a Congressional strategy for some in Washington, the effects of saying no to health care reform will be felt much sooner than later for millions of American seniors.Starting Monday, doctors serving patients in Medicare will face a 21% pay cut because the so-called ?doc fix?was just one of many reforms lost when healthcare reform was shelved.Current law says reimbursement rates for doctors must be based on a formula tied to the economy?s health. A ?doc fix? was included in health care reform legislation to provide a longer-term solution rather than the annual rite of temporary fixes. However, no health care reform has meant no doc fix of any kind. Now physicians have to decide, take the 21% pay cut or close their practices to Medicare patients.CNN reports on the American Medical Association?s response to what this ?just say no? approach in health care reform will mean for seniors:

“To our physicians, we are providing information on their Medicare participation options, including how to remove themselves from the Medicare program,” said James Rohack, president of the American Medical Association.

and according to Dr. Edward Kornel, a New York neurosurgeon:

Kornel said consumers should prepare for some difficult days ahead. “If doctors drop Medicare patients, these people will be forced to go to clinics where it’s hard to get appointments, the waits are long and you get far less attention than you would otherwise get,” said Kornel. “I think this situation is headed for disaster.”

Democratic leaders in the Senate attached a temporary doc fix to the unemployment legislation due for a vote yesterday. However, Republican lame-duck Senator Jim Bunning, is blocking that vote from happening.Modern Healthcare described it this way:

Senate Majority Leader Harry Reid (D-Nev.) had fast-tracked legislation meant to temporarily extend a number of expiring provisions, part of which includes the so-called ?doc fix,? as well as an extension to COBRA subsidies, unemployment insurance and a host of smaller Medicare items. Most of those provisions are set to expire at the end of the month. The Democrat-backed bill would allow those provisions to carry on for at least one month at a cost of $9.2 billion. But according to several sources, Republican leaders want to see that the package is fully paid for first. An attempt late last year to pass a longer-term bill that would have effectively scrapped the sustainable growth-rate formula, or SGR, also failed to pass the Senate.

?Just Say No?, ?Starve the Beast?, ?Keep the government out of my Medicare?… catchy slogans with serious repercussions for America?s seniors.Pay cuts for doctors and reduced physician access, a growing doughnut hole in Medicare Part D, escalating premiums and cost sharing and ultimately insolvency for a program burdened with the same skyrocketing health care costs seen system wide. These are the real-world implications of this ?just say no? approach and America?s seniors may pay the biggest price for inaction…and soon.