Medicare payment cuts: It's time for Congress to act

Medicare pay policy, with physicians facing drops in reimbursement in the immediate future, is creating access problems for patients.

Editorial. April 8, 2002.

The front page headline in the March 17 New York Times couldn't have been any more direct: "Many doctors shun patients with Medicare."

This and other recent news coverage represent important, independent acknowledgement of a health care crisis in the making. The AMA has ceaselessly warned about it in the past few months. The situation is a direct result of Medicare physician payment cuts that greatly threaten the access of Medicare patients to physician services.

Without fundamental changes, physicians face a 17% drop in Medicare pay from 2002 to 2005. Uncorrected, this will put Medicare pay in 2005 at less than it was in 1993.

The predictable result of this bizarre back-to-the-future scenario is that doctors will be forced to limit or forgo seeing Medicare patients. It has already begun.

This is not the course those doctors would choose, if they had any realistic alternative. Nevertheless, doctors pay rent, they have staff salaries to cover and other expenses, including the threat of a major increase in already costly medical liability rates. Something's got to give and Medicare's actions dictate that what will be lost is a considerable portion of patient access.

The overall percentage of physicians willing to take on all new Medicare patients has already slipped in recent years, from 71.8% in 1997 to 67.5% last year. Expect such declines to increase substantially if this situation is not remedied. In rural areas it will be worse. Doctors there are fewer and farther apart, and they are already paid considerably less by Medicare than their urban counterparts. [...]