There Is a Congressional Committee That Sets the Prices for Your Profession. You Have Never Heard Its Name.
Forty-five members write the tax code. Through it, they set what Medicare pays you, what you owe in April, and whether the hospital across the street pays anything at all.
Four things govern your entire career.
What Medicare pays you.
What you owe the IRS.
Why the hospital buying your practice pays no tax.
One committee writes all four. You cannot name it.
IN TODAY’S ARTICLE:
The four levers one committee controls: your Medicare pay, your income tax, the hospital exemption, drug prices
How a payroll tax quietly hands your reimbursement to the tax-writers
What “tax expenditure” means, and why $300 billion of it never shows up as spending
Why $28 billion in hospital tax breaks bought only $16 billion in charity care
Glossary at the bottom of today’s article.
THE RATE DID NOT COME FROM A PHYSICIAN
Let’s skip the sugarcoating: the number Medicare pays you was not set by anyone who has ever treated a patient.
A health committee did not set it.
There is no health committee setting your Medicare rate. There is a tax committee. You have never heard its name. That is not an accident.
The committee is called the House Ways and Means Committee.
It is the oldest committee in Congress, seated in 1789.
Its job is revenue. Taxes. Tariffs. Trade.
And the programs that run on dedicated taxes.Medicare is one of those programs.
So the committee that writes the tax code also determines your profession’s price. Most physicians practice an entire career without ever learning the name of the body that decides what their work is worth.
The cartel counts on complexity to hide in plain sight. This is the clearest example you will ever see.
HOW A TAX COMMITTEE BECAME YOUR HEALTH COMMITTEE
Here is the mechanism. It is the whole game, and it takes one paragraph.
Medicare Part A, the hospital insurance side, is funded by the Medicare payroll tax, the 1.45% line on every pay stub in America. Because dedicated tax funds fund Part A, it belongs to the committee that writes tax law.
That is what “jurisdiction” means. Jurisdiction is a committee’s exclusive authority over a subject. If a bill touches that subject, it dies unless it passes through that committee first. No detour. No floor vote around it.
Medicare runs on a tax. The tax committee owns the tax. So the tax committee owns Medicare.
The money comes in as a payroll tax. It goes out as your reimbursement. The committee that writes the tax writes both ends.
A tax committee controls your Medicare rate because Medicare is, structurally, a tax program. Read that twice. It is the sentence the entire system is built to keep you from understanding.
One point of accuracy, because receipts matter. Ways and Means does not own all of Medicare alone. It owns the tax-funded core, Part A, and shares Part B with the Energy and Commerce Committee. Medicaid sits entirely with Energy and Commerce. The tax committee owns the part that runs on the tax. That is enough.
