Thursday, October 22, 2009

A Sad Irony

Senate Democrats lost a key vote October 21st on a $247 billion dollar measure to avoid decreased Medicare reimbursement payments to doctors over the next 10 years. This would not have been an increase, but would have simply kept them at the same level they are now. The proposal was blocked in a 47-to-53 vote and thirteen Democrats broke with their party's leadership to join a unanimous Republican opposition.

Why is this a big deal? Well, the irony of this vote is that is that we may be passing health care reform to expand care availability to the general public, while decreasing access for Medicare patients to needed primary care if this vote stands.

This measure had been separated from broader proposals to overhaul the nation's health care system, because it is a separate problem that predates health care reform proposals. Under the current formula, Congress balances the Medicare budget by decreasing doctors payments to compensate for increased utilization by the public. Primary care is hit particularly hard, since those doctors have high office overhead costs that must be paid. A 21% cut is planned for January 1st, and 10% cuts are foreseen every year thereafter. Since doctors are already limiting access for Medicare patients due to existing low payments, it does not take a genius to understand that this payment decrease will be a catastrophe for Medicare patients. How sad that 53 members of the United States Senate either do not to understand that, or cynically do not care.


EL said...

I am very disappointed to hear about this vote. What seemed like an opportunity now appears to be regression.

Is it possible that Doctors could be REQUIRED to accept medicare patients? Or are such rules unlikely? I understand it would put family docs especially out of business but wondering how else medicare patients will find a medical home, especially in states where reimbursements are already so low (such as Washington State).

David A. Lynch, M.D. said...

One way Medicare patients can still be served is when doctors work with innovative Medicare Advantage companies that support primary care. That is what we do, and in my practice we require all of our new Medicare patients to pick one of the companies we accept. It has allowed us to still be able to see new patients.