Talk of the Town: Medicare going down a very dark road
When Medicare was created nearly 45 years ago, our nation promised elderly and disabled patients they would no longer go without needed health care. For 45 years, our parents and grandparents have invested in the system. They continue to pay through monthly premiums. But we are breaking our promise to 25 percent of elderly and disabled patients who are seeking a doctor because they cannot find one who is accepting Medicare patients.
Why is this? Because Congress routinely fails to permanently change the law that requires Medicare to slash its payment for physician care. Instead, Congress approves temporary postponements that have frozen Medicare payment at 2001 levels. On June 1, a 21 percent pay cut took effect. Because TRICARE - the health plan for members of the military and their families - cannot exceed Medicare payments, this cut also threatens health care for those in the armed services and their loved ones. The impact of this badly flawed Medicare payment system of access to care is particularly problematic for Arizona, where there is already a serious shortage of physicians.
Family physicians were already straining to make ends meet with Medicare payment rates. Today's family physicians are paying their nurses, physician assistants and other staff with 2010 wages. They are paying for electricity, heating and water at 2010 rates. They are buying medical supplies and equipment at 2010 prices. But with a 21 percent pay cut - after nine years of nearly frozen Medicare payments and nine years of inflation - family physicians are paying 2010 prices with what amounts to 1994 income. This will cripple their ability to continue caring for their Medicare and TRICARE patients.
Congress has reneged on its promise of ensuring access to health care for their elderly and disabled constituents. Legislators must act immediately to retroactively repeal this pay cut and replace the deeply flawed SGR formula with a permanent replacement that reflects actual practice costs that physicians experience.
Short-term fixes are not the right solution for Medicare patients, physicians or the health care system. However, until Congress passes a permanent fix, AAFP is calling on Congress to pass a measure that cancels the pay cut until at least Dec. 31, 2012, and that includes a differentially better payment for primary medical care. This action will temporarily stabilize the Medicare system, allowing physician practices to plan for the next 31 months and easing the uncertainty for Medicare and TRICARE patients. It also will signal that federal policy recognizes the important role of primary physicians in ensuring high-quality health care.
The political gamesmanship must end. A comprehensive and stable Medicare payment system must be put in place. The time to begin that process is now.
Jeffrey Wolfrey, M.D., is president of the Arizona Academy of Family Physicians.