Senate Inaction On Medicare Hurts Seniors, Military and Boomers

/PRNewswire/ -- A Medicare meltdown now seems certain, as the U.S. Senate has left early for the weekend, abandoning seniors, military families and baby boomers. The Senate failed to repeal the Medicare physician payment formula that will cause a drastic 21 percent payment cut to physicians who care for Medicare and TRICARE patients. On Monday, the 21 percent cut goes into effect, forcing physicians to consider the difficult decision to limit the number of Medicare and TRICARE patients they see in order to keep their practice doors open.

"Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them," said AMA President J. James Rohack, M.D. "It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games."

Already, about one in four Medicare patients seeking a primary care physician is having trouble finding one, according to MedPAC, Congress' advisory body on Medicare. Physicians have told AMA that steep Medicare cuts will force them to limit the number of Medicare patients they treat. A new 2010 survey of neurosurgeons found that 60 percent are already reducing the number of Medicare patients in their practices, and cuts will force nearly 40 percent to decrease the number of new Medicare patients they see. More than 18 percent of neurosurgeons will no longer take new Medicare patients.

"The Senate had more than a year to repeal the formula and ensure the security and stability of Medicare and TRICARE, but that opportunity has been squandered," Dr. Rohack said. "This drastic cut will hurt our senior, disabled and military patients, as well as baby boomers who start entering the Medicare program next year."

"Last November, the U.S. House passed legislation (H.R. 3961) that would repeal the broken formula and better update payments to reflect the increasing cost of care," Dr. Rohack said. "AARP and the Military Officers Association of America (MOAA) have joined with the AMA in calling on the Senate to act, but the Senate has turned its back on America's seniors, military families and baby boomers."

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Concord Coalition Says That Medicare 'Doc Fix' Should Be Paid For

/PRNewswire/ -- The Concord Coalition said today that if Congress raises physician reimbursement rates in Medicare, it should spell out how to pay for the changes.

The Senate is expected to consider a bill this week that would permanently increase physician reimbursement rates relative to the current Medicare "sustainable growth rate" (SGR) formula and exempt this "doc fix" from pay-as-you-go budget rules (PAYGO). This exemption would increase federal deficits by roughly $250 billion over 10 years.

Concord said that changes in the payment formula should be included and paid for as part of comprehensive health care reform. The issue of how Medicare reimburses physicians is central to the broader effort to get Medicare and health spending in general onto a more sustainable path.

"Dealing with the 'doc fix' in a separate bill, outside of health care reform, would change the scoring of the bills but not the effect on the deficit. If policymakers believe that the current SGR formula is unrealistic, they should replace it with a more appropriate policy and pay for the change in keeping with their pledge to reform health care in a deficit-neutral way. If paying for this SGR change means there would be fewer offsets on the table to pay for expanded coverage, then policymakers would be forced to appropriately weigh their priorities and make the necessary tough choices -- either scale back other costs in the health reform package or find more ways to pay for the larger bill," said Concord Coalition Executive Director Robert L Bixby.

Bixby said that deficit-financing a permanent increase in Medicare physician payments does not bode well for eventually "bending the health cost curve" and improving fiscal sustainability more generally.

"The current SGR payment formula was originally enacted as part of the 1997 balanced budget agreement to slow the growth of physician payments. Exempting a change in that formula from PAYGO would undermine the credibility of promises now being made to restrict provider payments in the future. Why should anyone believe that Congress will enforce future promises to limit provider payments when it cannot summon the political will to enforce the limits it has already enacted?" Bixby said.

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