Senator Hears Physicians' Complaints

By Robin Williams Adams
The Ledger
http://www.theledger.com

Problems with traditional Medicare and alternative Medicare HMOs were on doctors’ minds Wednesday when U.S. Sen. Mel Martinez visited Watson Clinic to meet clinic executives and speak on health care.

More than 100 people, mostly physicians and clinic officials, applauded several times as Martinez talked about Medicare, providing better access to health insurance, the shortage of medical professionals and other issues before Congress.

But some also made sure Martinez heard how Medicare paperwork and government budget-cutting has affected them and their patients.

Dr. Elisabeth Dupont, a breast surgeon, told Martinez a Medicare HMO increased patients’ co-payments from $10 to $75, a charge it will levy each time one of her patients has radiation treatment for breast cancer.

“She needs 35 radiation treatments at $75 (each time),” Dupont said. “She is thinking about doing a mastectomy because of this. This is not acceptable.”

The $75 co-payment is more than his regular Medicare charge for an office visit, another specialist said.

Martinez was told of the frustration stemming from constant threats to reduce Medicare payments, often temporarily resolved at the last minute with six-month delays; the difficulty in getting paid for preventive health care; and how doctors feel pressured to see so many patients they can’t spend enough time with them.

“I love my job,” said Dr. Richard Cardosi, a gynecologic oncologist. “I’m happy. Things are great … (but) I have a hard time encouraging my children to go into a field that’s that uncertain.”

Republicans and Democrats agree the health-care system, not just Medicare, needs an overhaul, Martinez said. They disagree on the best ways to do it, one of several reasons he said meaningful reform is unlikely until after the November presidential election.

The Florida Republican sympathized with the concern about Medicare payments, saying a “little Band-Aid six months at a time” isn’t going to cure the system’s ills.

In December, lawmakers approved a so-called “doctor fix,” which replaced a scheduled 10 percent cut to the Medicare physician reimbursement rate in 2008 with a 0.5 percent increase. It extends only through June 20, however, creating uncertainty for doctors.

“You cannot continue to fix the problems of the Medicare system exclusively on the backs of doctors,” Martinez said, adding, “We do not have enough wealth in the country to support the present system.”

On the issue of improving access to health care for 47 million nationwide who are uninsured, Martinez said every American should have access to health care. He wants most to be able to get private insurance, however, rather than going into a “government one size fits all.”

That’s one policy division – expanded government programs or more incentives to buy private insurance – dividing federal lawmakers and presidential candidates.

Turning to an issue he said has assumed more meaning to him as an aging baby boomer, Martinez, 61, said the shortage of doctors, nurses and other health professionals is a major problem for Florida.

Solutions he endorsed include more residency training programs, loan-forgiveness programs, additional funding for medical education and encouraging professionals from other countries to practice here. He told doctors and nurses to promote health-care careers, reminding them their children hear their complaints about the system, which could discourage those children from going into medicine.

“More than ever, we’re going to be needing the medical profession,” Martinez said. “It ought to be a big national priority.”
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