Health Care

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Doctors, Doctors Everywhere but not a Doc to Treat

Medicare reform may seem to affect only a portion of the population, but actually, Medicare affects all of us. The changes that occur in Medicare will impact the entire healthcare industry. Congress is forming legislation that will create a ripple effect: new Medicare laws will influence more than Medicare; they will also affect the private healthcare system, the drug companies, hospitals, doctors, nurses, and of course, us, the patients.

It is clear to see the importance of new Medicare legislation when we look at the impact of existing legislation. Right now, Medicare law ties Medicare spending to economic growth. This means that when the economy falters, Medicare must cut spending.

This is a problem because the healthcare needs of the elderly do not go up and down with the economy. In fact, the demand for doctor visits and prescription drugs has been increasing in the midst of economic recession. This is a harmful equation for Medicare.

The Bush administration has proposed cuts in Medicare payments to doctors for the second year in a row.

Doctor drain

Last year, doctors received 5.4% less from the government. (The government reimburses doctors for the cost of treating Medicare patients.) The Bush administration is proposing another 4.2% cut for next year. Clearly, these cuts discourage doctors from taking any new Medicare patients.

The Bush administration claims that only Congress can stop the 4.2% cut for next year; they suggest that Congress add a provision to the prescription drug legislation in order to remedy the problem. This, of course, advances the administration’s desire to get its private sector changes into the Medicare structure. Some members of Congress feel that the administration can do something to prevent cuts in doctor payments without the Bush plan for Medicare to compete with private insurance companies.

It doesn’t happen often

Republicans in Congress usually agree with the President, but in this case, House Republicans Bill Thomas of California, Billy Tauzin of Louisiana, and Nancy Johnson of Connecticut think that he is wrong. Thomas,Tauzin, and Johnson claim that the Bush administration can avoid the cut in doctor pay by reworking the payment formula.

Currently, the Bush administration is factoring in drug costs in its estimation of the growth in Medicare spending on doctors’ services. Thomas, Tauzin, and Johnson believe that this is unfair because drug costs are increasing much more rapidly than other healthcare costs.

Fundamentally flawed

Altering the formula that is used to predict future healthcare spending may solve the problem in the short term, but Congress would need to untangle Medicare from the economy if it hopes to permanently solve this issue.

The House version of the prescription drug legislation includes a 1.5% yearly raise in doctor payments, but in a serious recession, this raise will not prevent cutbacks. The Senate version of this bill claims that the payment formula is “fundamentally flawed" and suggests that it be completely overhauled. However, the Senate does not offer a tangible solution, its bill only expresses its opinion, or “the sense of the Senate."

Who will suffer?

Doctors will be receiving less payment for their Medicare patients and to make up for the lack of funds, doctors will cut costs in other areas. They will also stop taking Medicare patients. So, where are Medicare beneficiaries supposed to go if all doctors put a cap on the number of Medicare patients that they treat?

It is possible that this Medicare cut could mean crisis for Medicare patients. Unless Congress or the Bush administration offers doctors some other incentive to take Medicare patients, these patients may have trouble finding a doctor who will treat them.

Government needs to act fast. The cut will go into effect on January 1, 2004 if no one remedies the situation.

Suggestion Box

The Bush administration is accepting public commentary on its proposal. Until October 7, 2003, the American people can let Bush know how they feel about the cuts. Our representatives need our votes, so the public response is sure to have some influence.

To contact the Bush administration with your thoughts on this issue, [click here]. To discuss the idea with other WomenMatter readers, [click here].

Posted on: 8/15/2003

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