Future of access to Medicare bleak


In July, the government health insurance program for seniors and the disabled will automatically begin draconian payment cuts to physicians. Over a year and a half, the cuts translate to a loss of $200 million to Washington physician practices caring for Medicare patients.

The more than 785,000 patients who rely on Medicare in Washington will bear the brunt of the cuts to physicians, as doctors are forced to make tough decisions because of cuts that push payments far below the increasing cost of providing care. This is not a hypothetical situation: Sixty percent of physicians say this year’s cut will force them to limit the number of new Medicare patients they can treat.

In three years, the first wave of baby boomers will reach Medicare age, and the Medicare rolls will keep expanding as one-fifth of the U.S. population will be over age 65 by 2030. Compound that with the fact that we’re already beginning to feel the effects of a looming physician shortage, and the future of seniors’ access to care may be dire.

Current Medicare payments to physicians are about what they were in 2001, while the costs of running a medical practice increase. And now Medicare projects cuts of more than 15 percent over a year and a half. If the cuts aren’t stopped, having a Medicare insurance card will not guarantee access to physician care.

Intervention by Congress is the only way to stop the cuts, as they occur automatically because of a flawed mathematical equation. Time is running short for action.

The silver lining of the cloud is a bipartisan commitment to preserving seniors’ access to care and legislation introduced by Michigan Sen. Debbie Stabenow and cosponsored by Washington Sen. Patty Murray. If enacted, the Save Medicare Act of 2008 (Senate Bill 2785) would replace 18 months of Medicare physician payment cuts with payment updates that better reflect medical practice cost increases. Taking action for more than one year is critical to inject some stability into the system for seniors and their physicians.

The alarm bells already are ringing: The Institute of Medicine just released a report on the problems of caring for a graying America and called for more training in geriatric care and higher Medicare payments to physicians. MedPAC, Congress’ advisory commission on Medicare, found that 30 percent of Medicare patients seeking a new primary care physician have trouble finding one and recommends increasing Medicare physician payments. Last but not least, the government predicts an overall shortage of 85,000 physicians by 2020, just as baby boomers flood Medicare.

A recent public poll found that nearly three-quarters of Americans want Congress to stop the cuts to preserve seniors’ access to care, and lawmakers hear directly from concerned citizens through the AMA’s Patients Action Network. Immediate congressional action will demonstrate real leadership as we work to preserve access to care for current and future generations of Medicare patients.

Edward Langston, M.D., is board chairman of the American Medical Association.

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