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Tue, March 19

MEDICARE in crisis: The patients

Bob Jacobsen, an 82-year-old World War II veteran from Prescott, lost the services of a much-needed orthopaedic surgeon several months ago when the physician dropped him because he is on Medicare.

The Prescott surgeon told Jacobsen that he was no longer accepting new Medicare patients, even though Jacobsen had been an existing patient with the doctor for a while.

When Jacobsen went in for a regular visit, the physician told him that his insurance wasn't valid at the office. In other words, if the surgeon had to accept any payment from Medicare through a private insurer, he would not schedule an appointment.

Jacobsen said the doctor gave no reason for dropping him. A retired engineer, Jacobsen said he can't afford his medical bills without Medicare because he and his wife are on a fixed income.

Situations such as Jacobsen's could become much more common as Congress' approval Friday of legislation to spare doctors a 21 percent pay cut in Medicare payments came too late. Moments after the Senate acted, Medicare announced it would start processing claims it has already received in June at the lower rate. The House of Representatives can't act on the fix until next week.

For years, Congress has considered cutting Medicare funding because of the rising costs of medical supplies and services due to inflation. If the federal government doesn't halt these cuts, more doctors will start decreasing the number of Medicare patients they see to keep their practices afloat financially.

"Fortunately, most of the specialists (that I need) I'm pretty well finished with right at the moment," said Jacobsen, who still suffers from a knee ailment. "Right now I don't have an alternative, unfortunately."

Although Jacobsen has chronic pain in his knee and hip, those problems were not related to his military service.

He said he doesn't suffer from any reoccurring problem that a specialist could likely correct. The only reason he wanted to continue visiting his former surgeon was that he could have some possible consequences from the knee surgery the doctor performed on him. Jacobsen also had an operation for a broken hip about three years ago at Yavapai Regional Medical Center in Prescott.

While the more recent knee surgery successfully repaired bone damage in his left knee, it did not improve the numbness, lack of feeling and other chronic problems he's had with his leg.

Jacobsen said he now has a sleeping disorder and lacks complete balance when he walks.

"Along with one of these treatments, my sciatic nerve was damaged to where I have almost no feeling in my left leg," he said.

Despite his problems, Jacobsen has held on to his Phoenix-area primary care physician who gives him annual physicals and checks him for conditions that require attention.

"I'm praying and hoping that nothing else (bad) happens because I can't afford it if I can't find a doctor that takes Medicare up here," he said.

***

Yavapai Regional Medical Center offers help for patients such as Jacobsen, who said he has not yet called YRMC for guidance on picking up another surgeon/specialist who accepts Medicare.

Seymour Dicker, a YRMC volunteer and retired trial lawyer from New York, has spent several hours a week for the past few years matching Prescott-area patients on Medicare with local doctors who accept Medicare patients.

Dicker keeps a book that lists all Prescott-area doctors, where they're located, their phone numbers, and whether they take Medicare and/or private insurance. He said several physicians in Prescott and Prescott Valley are currently accepting Medicare patients, including new ones.

"Of course that fluctuates depending upon how busy the doctors' offices get, because there's always people moving here and sometimes the numbers shift," Dicker added.

Once President Obama's health care plan, which Congress approved earlier this year, goes into effect, the medical community is worried about the effects that the legislation might have on Medicare.

The concern is that as more people from the Baby Boom generation retire and go on Medicare, the taxpayer dollars will not be there for the doctors to see them.

"I would imagine if a doctor's office gets full and he feels he cannot handle any more patients, he will stop taking new patients," Dicker said. "But I can't see too many doctors here opting out of Medicare altogether because, let's face it, we have an elderly population."

Dicker said 90 percent of the people who have just moved to the Prescott area and call him seeking a doctor are on Medicare.

"It's pretty hard to tell exactly what's going to happen (with the Obama plan), but right now we're in a very stable condition, and the hospital is always working to bring new doctors into the area as Prescott and Prescott Valley grow," he said. "I don't think in the years that I've been doing this there has been one person who was looking for a doctor that we have not been able to set them up with at least a choice of doctors who take Medicare."

To reach Dicker or another volunteer at the hospital about finding doctors and specialists that accept Medicare, call the physicians referral line anytime from 8 a.m.-noon Mondays through Fridays at 928-771-5106. If no one picks up, leave a message with a name and telephone number and a volunteer will return the call.

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