Rural doctors seek equal Medicare pay

Others worry that the geographic disparity issue will take the focus away from an update fix.

By Markian Hawryluk, AMNews staff. July 22, 2002.

Chicago -- At the American Medical Association's recent Annual Meeting in Chicago, few issues were as divisive as the geographic disparity of Medicare payments to physicians.

It's not that physicians in urban areas couldn't sympathize with their rural counterparts. Many were just concerned that a fight for less variation in payments from region to region would distract lawmakers and public officials from the deep cuts in Medicare payments affecting all physicians.

Rural delegates ultimately persevered, and the House of Delegates voted to push for legislation that would reduce geographic disparity.

Less a month after the debate, Congress may be poised to address both issues. Medicare legislation passed by the House in early July included an update fix and provisions that would partially address the geographic variation in payments. The Senate is expected to take up a Medicare bill in July, but Senate leaders have been tight-lipped about their plans for physician payments.

A solution to the geographic difference problem could not come soon enough for a coalition of 15 rural state medical societies that pushed for the AMA to resolve the situation. For rural physicians, it's an issue of fairness for both themselves and their beneficiaries.

"My patients pay the same Medicare payroll taxes as people in other states, they suffer the same illnesses, get the same treatment from the same types of health providers, yet Minnesota Medicare beneficiaries received on the average $4,800 of Medicare benefits in 2000," said Anthony Jaspers, MD, a family physician from Lake Crystal, Minn. "That's 13% below the national average of $5,500." That means taxes paid by Minnesotans are being used to pay for Medicare beneficiaries in other states, he said. "Medicare is a national program and should treat all seniors equally." [...]