GOP Defeat of Bill to Fix Problem in Medicare
Physician Pay Devastating to Doctors, Seniors
Doctors face 21% pay cut from Medicare in 2010; same
annual quandary Democrats tried to fix; senior citizens many find it
harder to get a doctor; AMA issues new list of states with problems
By
Tucker Sutherland, editor & publisher
SeniorJournal.com
Oct.
22, 2009 – An annual event for years has been the threat of a Medicare
pay cut for doctors, caused by an automatic
payment formula for physicians that takes in annual data and
spits out a demand that doctors’ pay must be cut. This is followed by
the physicians' lobbyists and medical associations rushing to
Washington, campaign cash in hand, to get the Congress to magically
transform the pay cut into a pay hike. - which they always do.
It is a painful experience for doctors, as it would
be for anyone who knows their pay is going to be cut at the end of every
year, and that they are going to have to make financial contributions
and do considerable begging before the pay is restored or increased for
another year.
The formula has already kicked out its Medicare/TRICARE
pay mandate for 2010 and it says physicians’ pay should be cut by 21
percent in 2010.
During this annual event
there is considerable worry placed on the shoulders of senior citizens,
too, who are told that due to the pay cut by Medicare, physicians are
going to stop treating Medicare patients. If there are no doctors
treating Medicare patients, there is no Medicare.
Democrats joined the
American Medical Association in saying, “Enough is enough.” The formula
had to be changed.
Senator Debbie Stabenow (D-MI) leads the charge
Senator Debbie Stabenow
(D-MI), a frequent sponsor of legislation for senior citizens, took the
lead and introduced the Medicare Physician Fairness Act (S. 1776). The
bill, she” said, “would have protected Medicare for the future by
permanently repealing a flawed payment system so that doctors will
continue serving Medicare seniors and TRICARE (military retirees)
recipients.”
She said she wanted to
“fix this payment system, so doctors wouldn’t be forced to close their
doors to patients who trust and need them.
“I am disappointed that
we did not have the votes to proceed to this critical bill, but I will
continue my effort to work with the White House and leadership
(Democratic) to strengthen Medicare and shift the focus to paying for
quality of care rather than quantity of treatments.”
The bill never actually
got to a vote on its merits. It was stopped by the failure of a motion
to bring the legislation to a vote of the Senate. The motion failed by a
vote of 47 to 53. Opposition was led by Republicans, although 13
Democrats voted with them.
“The AMA is deeply
disappointed that the Senate today blocked consideration of S. 1776,
legislation to preserve access to health care for America’s seniors,
baby boomers and military families,” said Dr. J. James Rohack,
President, American Medical Association.
“Senator Stabenow is a
long-time champion for patients and physicians, and the AMA, AARP and
MOAA strongly supported her bill that would have laid the foundation to
permanently fix the Medicare physician payment formula and keep Medicare
strong as millions of baby boomers enter the program in just two years.
Sen. Stabenow also drew praise from the Dr. Lori
Heim, President, American Academy of Family Physicians, who said
Stabenow “worked to put an end to the annual congressional scramble to
prevent severe cuts in payment to doctors who care for Americas elderly
and disabled patients.”
“The failure to bring this legislation to a full
Senate vote continues a status quo that cannot be sustained and
increases the ultimate cost of resolving Medicare physician payment
problems. It maintains a system that contributes to the instability of
the Medicare program and the continuation of a broken system that pays
for procedures rather than for quality. It prolongs a system that
increasingly threatens Medicare beneficiaries access to needed health
care services. In short, it props up a system that contributes to the
problems that health care reform must resolve.”
Republican Sen. Bob Croker voted against it
A Republican who opposed
the legislation, Sen. Bob Croker (R-TN) said the bill “eliminates
the SGR (Sustainable Growth Rate) Medicare payment model without
replacing it with another and adds $246.9 billion to the debt.”
“I have consistently voiced strong support for a
permanent solution to the ‘SGR’ dilemma and wholeheartedly believe it
should be fully addressed – along with its cost,” added Corker.
“While I strongly believe in healthcare reform that
will stand the test of time, Americans should recognize this vote as the
first test of the healthcare debate, a test that the Obama
administration and Democratic leaders flunked. Right out of the gate
they offered a two-page bill that adds $246.9 billion to our deficit as
a quid pro quo to buy the American Medical Association’s support of
health care reform.
Some seniors are asking if this is not the same old
GOP opposition that is based the political game of who wins and who
loses, rather than what is good for America and their states.
The AMA points out that “Sen. Croker’s Tennessee
seniors are among the poorest in the nation, with 35 percent living
below 150 percent of poverty. Medicare cuts to physicians caring for
seniors will hurt access and choice of physician.”
AARP’s Senior Vice President David Sloane said the
bill’s defeat proves “once again Washington lawmakers would rather play
political games that protect the needs of seniors.”
He added, “The Senate’s failure to fix the flawed
doctor payment system means that payment rates for doctors in Medicare
could be cut by 21.5 percent in just a few months. Short-term patches to
preserve physician pay
“Without repeal, physicians face Medicare cuts of
about 40 percent over the next five years,” said AMA President-elect
Cecil Wilson, M.D. “In two years, the baby boomers will begin to reach
Medicare age, and they will expect access to high-quality medical care
to stay healthy and active as they age. Physicians want to provide this
care, but they need to know that Medicare will cover the cost of
providing 21st century medical care.”
AMA Releases List of 22 New Hot Spots Where
Seniors May Have Trouble Finding a Doctor
Highlighting the impact of looming Medicare
physician pay cuts on seniors’, the American Medical Association
released a new analysis of states where access to care for Medicare
patients is already at risk. Twenty-one states and the District of
Columbia made the AMA’s new “Patient Access Hot Spots” list, which is
based on their ranking in the top 15 of at least two of five objective
measures of access problems.
“This new analysis shows that seniors’ access and
choice of physician is already threatened, and bolsters the case for
permanent repeal of the flawed payment formula that projects the
Medicare cuts,” said Dr. Wilson.
These new finding affirms independent research from
Congress’ Medicare advisory committee (MedPAC) that found that 28
percent of Medicare patients looking for a new primary care physician
had some problem finding one.
The AMA analyzed state-level data on five measures
of access and identified the top 15 states on each measure. The 22 hot
spots are based on their ranking in the top 15 of at least two of five
objective measures of access problems:
1. Practicing
physicians per 1,000 Medicare beneficiaries.
2. Medicare
beneficiaries age 65 and over living below 150 percent of the federal
poverty level.
3. Estimated
underserved population living in primary care health professional
shortage areas.
4. Hospital emergency
room visits per 1,000 population.
5. Percentage reporting not seeing a doctor in
the past 12 months because of cost.
Alabama
“Alabama has just 13 practicing physicians per
1,000 Medicare patients and steep Medicare cuts to physicians will
further hurt seniors’ access and choice of physician,” said Dr. Wilson.
“There are 487 emergency visits per 1,000 population and 19 percent of
the state’s residents live in a health professional shortage area.”
Arkansas
“With just 12 practicing physicians per 1,000
Medicare patients, Arkansas has one of the lowest physician-to-patient
ratios in the country and steep Medicare cuts to physicians will further
hurt seniors’ access and choice of physician,” said Dr. Wilson. “More
than 30 percent of seniors in Arkansas are living below 150 percent of
the federal poverty level.”
District of Columbia
“As lawmakers work in the nation’s capitol to
strengthen the security and stability of Medicare, it’s important to
note that one quarter of Washington, DC residents live in a health
professional shortage area, and there are 784 emergency visits per 1,000
population,” said Dr. Wilson. “Thirty-five percent of seniors in the
District live below 150 percent of the federal poverty level.”
Florida
“With nearly three million Medicare patients and
only 15 practicing physicians per 1,000 Medicare patients, it’s vital
that Congress ensure seniors’ access and choice of physician,” said Dr.
Wilson. “Fifteen percent of the state’s residents live in a health
professional shortage area.”
Georgia
“Steep Medicare cuts to physicians will hurt
Georgia seniors’ access and choice of physician,” said Dr. Wilson.
“Nearly a third of Georgia seniors on Medicare are living under 150
percent of the federal poverty level and 16 percent of Georgia residents
report not seeing a doctor in the past 12 months due to cost.”
Idaho
“Much of Idaho is underserved by physicians with 17
percent of the state in a health professional shortage area and just 14
practicing physicians per 1,000 Medicare patients – steep Medicare cuts
will make the problem worse,” said Dr. Wilson.
Indiana
“With a ratio of 15 physicians per 1,000 Medicare
patients, Indiana seniors will be hurt by Medicare cuts to physicians,”
said Dr. Wilson.
Kentucky
“Kentucky has just 14 practicing physicians per
1,000 Medicare patients and one third of the state’s seniors live below
150 percent of the federal poverty level – Medicare cuts to doctors will
make the problem worse,” said Dr. Wilson.
Louisiana
“About 34 percent of Louisiana residents live in
health professional shortage areas and 36 percent of the state’s seniors
are living below 150 percent of the federal poverty level – Medicare
cuts to doctors will further erode seniors’ access and choice of
physician,” said Dr. Wilson.
Massachusetts
“Twenty-nine percent of Massachusetts seniors on
Medicare are living below 150 percent of the federal poverty level, and
we’re concerned that cuts will further erode seniors’ access and choice
of physician,” said Dr. Wilson.
Mississippi
“Mississippi ranks near the bottom by every measure
of Medicare physician access, and cuts to physicians will further erode
seniors’ access and choice of physician,” said Dr. Wilson. “Mississippi
has just 12 practicing physicians per 1,000 Medicare patients and a
third of the state’s residents live in primary care shortage areas.”
Montana
“Nearly a quarter of Montana residents live in a
health professional shortage area, and there are just 15 practicing
physicians per 1,000 Medicare patients in the state - and cuts to
physicians will further erode seniors’ access and choice of physician,”
said Dr. Wilson
New Mexico
“The AMA is concerned that Medicare cuts will
further erode New Mexico seniors’ access and choice of physician as 32
percent of New Mexico residents live in a primary care shortage area and
31 percent of seniors in the state are living below 150 percent of the
poverty level,” said Dr. Wilson.
North Carolina
“Thirty-one percent of North Carolina seniors on
Medicare are living under 150 percent of the federal poverty level, and
we’re concerned that drastic cuts to physicians will further erode
seniors’ access to care,” said Dr. Wilson.
North Dakota
“North Dakota has just 15 practicing physicians per
1,000 Medicare patients and 22 percent of the state’s residents are
estimated underserved living in health professional shortage areas –
Medicare cuts to physicians will make the problem worse for seniors,”
said Dr. Wilson.
Oklahoma
“Oklahoma has just 14 practicing physicians per
1,000 Medicare patients, and 15 percent of Oklahoma residents live in
health professional shortage areas – Medicare cuts will surely make the
problem worse for seniors,” said Dr. Wilson.
South Carolina
“With 15 practicing physicians per 1,000 Medicare
patients and a third of South Carolina’s seniors living below 150
percent of the federal poverty level, the AMA is concerned that Medicare
cuts will further erode seniors’ access and choice of physician,” said
Dr. Wilson.
South Dakota
“With just 14 practicing physicians per 1,000
Medicare patients, many areas of South Dakota are underserved and 27
percent of the state’s residents live in health professional shortage
areas – the AMA is concerned that Medicare cuts will further erode
seniors’ access and choice of physician,” said Dr. Wilson.
Tennessee
“Tennessee seniors are among the poorest in the
nation, with 35 percent living below 150 percent of poverty, and
Medicare cuts to physicians caring for seniors will hurt access and
choice of physician,” said Dr. Wilson.
Texas
“One third of Texas seniors on Medicare are living
below 150 percent of the federal poverty level, and Medicare cuts to
physicians caring for seniors will hurt access and choice of physician,”
said Dr. Wilson.
West Virginia
“With nearly one in five residents on Medicare,
West Virginia has the highest proportion of the state’s population on
Medicare of any state,” said Dr. Wilson. “We are very concerned that
Medicare cuts will further erode seniors’ access and choice of physician
as there are already only 13 practicing physicians per 1,000 Medicare
patients.”
Wyoming
“Medicare cuts to physicians will further erode seniors’ access and
choice of physician in Wyoming as one in five residents live in health
professional shortage areas and there are just 14 practicing physicians
per 1,000 Medicare patients, far below the national
Keep up with the latest news for senior citizens, baby
boomers
Oct.
22, 2009 – An annual event for years has been the threat of a Medicare
pay cut for doctors, caused by an automatic 
