This July 1, the government health insurance program for elderly and disabled patients will automatically begin draconian payment cuts to physicians. Over a year and a half, the cuts will cost $20 million to Alaska's physician practices caring for Medicare patients. The real losers are Alaska's growing number of Medicare patients who will be left with reduced access to physician care.
The nearly 50,000 patients who rely on Medicare in Alaska will bear the brunt of the Medicare cuts to physicians as doctors are forced to make tough decisions because of cuts that push payments far below the increasing cost of providing care. This is not a hypothetical situation: 60 percent of physicians say this year's cut will force them to limit the number of new Medicare patients they can treat.
In three years, the first wave of baby boomers will reach Medicare age, and the Alaska Department of Labor estimates the state's population of people over 65 will triple by 2030. As more people rely on Medicare in the coming years, drastic cuts will undermine the program's physician foundation and heighten concerns expressed by the Institute of Medicine that the current health care workforce will be unable to meet the growing needs of the expanding senior population.
Current Medicare payments to physicians are about what they were in 2001, while the costs of running a medical practice have increased 20 percent in the past seven years. And now Medicare projects cuts of more than 15 percent over the next year and a half. If the cuts aren't stopped, having a Medicare insurance card will not guarantee access to physician care.
Intervention by the U.S. Congress is the only way to stop the cuts, as they occur automatically due to a flawed mathematical formula that ties payments to the ups and downs of the economy instead of the health-care needs of seniors. But time is running short for action.
The silver lining in the cloud is a bipartisan commitment to preserving seniors' access to care and legislation introduced by Sen. Debbie Stabenow. If enacted, the Save Medicare Act of 2008 (S. 2785) would replace 18 months of Medicare cuts with payment updates that better reflect medical practice cost increases. Taking action for more than one year is critical to inject some stability into the system for seniors and their physicians.
The alarm bells are already ringing: Congress' advisory commission on Medicare, MedPAC, found that 30 percent of Medicare patients seeking a new primary care physician report trouble finding an appointment. Compounding the health care access problem is a government-predicted shortage of 85,000 physicians by 2020, just as baby boomers flood Medicare.
There's an implicit contract between the government and the American people that Medicare will be the health care safety net for seniors and disabled patients. A recent poll found that nearly three-quarters of Americans believe Medicare's promise should be protected and want Congress to stop the cuts. Immediate congressional action will demonstrate real leadership as we work to preserve access to care for current and future generations of Medicare patients.
Edward Langston, M.D. is board chair of the American Medical Association.
By EDWARD LANGSTON, M.D.