Doctors, insurers split over Medicare
Some doctors are threatening to stop seeing Medicare patients if Congress goes through with cutting doctors fees more than 10 percent. Nancy Marshall Genzer reports both sides of the debate have taken to the TV airwaves.
Senior citizen puzzles over Medicare changes (Justin Sullivan/Getty Images)
More on Health, Fed. Budget/Govt. Spending
TEXT OF STORY
Scott Jagow: The U.S. Senate will grapple today with what to do about Medicare. Doctors' fees could be slashed by more than 10 percent as part of a cost-cutting move passed by Congress about a decade ago. Some doctors are threatening to stop seeing Medicare patients if the cuts take effect. Nancy Marshall Genzer has more.
Nancy Marshall Genzer: Senate Democrats want to block the cuts in doctors fees. They'd rather reduce subsidies to insurance companies to cut Medicare costs. Insurers have fought back with TV ads.
Health TV ads: Millions of seniors will have to pay higher out of pocket costs.
But doctors have also taken to the airwaves. Their ads are aimed at Republicans, who've sided with insurers.
Health TV ads: A group of U.S. senators voted to protect the powerful insurance companies.
Joseph Antos of the American Enterprise Institute says Congress bickers over this every year -- usually voting not to cut doctors' fees.
Joseph Antos: Congress needs to realize it can't keep kicking this problem down the road one year at a time.
Doctor Richard Brown of the UCLA school of public health says while Congress dithers over the fee issue:
Doctor Richard Brown: Ultimately, it's the patient who will lose out if those fees do not increase.
In Washington, I'm Nancy Marshall Genzer for Marketplace.
Comments
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From McAllen, TX, 07/14/2009
I couldn't agree with you more. Our rent has increased and so has our staff salaries as they have all been working with me for so many years and receive annual pay raises. This past month, despite working 70 hours a week; I haven't made enough "profit" to pay myself. I will have to start cutting back the office hours and firing staff. I can no longer see patients that cannot pay or do not have insurance...that was the good old days. If things don't improve; I will have to retire. If Medicare cuts physician reimbursement by 21% next year there is no way I can work for free which is what I will be doing after rent, payroll, malpractice, phone, supplies, answering service, long distance, insurance, postage, printing, etc. etc. has been paid out of what I receive. Some private insurances are paying me $9 for an office visit that takes 30 to 40 minutes of my time. Clearly that will close our doors as it won't even pay for an hour's time for one of my nurses and I employ seven.
From Lexington, LA, 07/09/2008
I am a physician in Lexington, KY. I caught the short mention of the Medicare 10.6% cuts on the air this morning. Lexington has one of the lowest Medicare reimbursement rates in the country (did you know it varies widely?) and yet we have one of the sickest populations. Over the past 5 years we have absorbed more than 20% cuts in Medicare, and over 30% decrease in commercial insurance reimbursement. Anthem/BC/BS just came to us with another 10% cut.
As physicians, our salaries have decreased dramatically. We are well below the national average for our specialty (orthopaedics) and have sacrificed our income to pay the staff cost of living raises. We face the same huge malpractice premiums as does the rest of the country, we have $4.15/gal gas, we pay more for everything, every day. It is astoniishing that Medicare and insurance companies think that we can absorbe more cuts. What other industry gets paid less every year, doing more work?
The Rep. side of Congress wants to keep the Medicare Advantage program. It is a huge rip-off for patients. Doctors tried to warn that this would not be cost-effective, but the insurance lobbies were louder. We watched Humana and others go to the Medicare administration and offer to "manage" medicare patients, if they were paid 120% of the normal medicare reimbursement. This represented a $7,000,000,000.00 windfall for the insurers. Unfortuantely they did not improve the Medicare system, they just added a layer of cost, and kept it as profit. Most Medicare Advantage programs are very confusing for patients, they offer no improvement in care, and few doctors will accept these patients, as the insurers are offering 95% of the normal reimbursement. One insurer offered our group a Medicare Advantage contract, we would have to pay them $5000.00 to join, and then they would pay us at 85% of the Medicare rate????????? We declined.
Our group is made up of very dedicated sub-specialists. We are the Orthopaedists that all other Orthopaedists refer to. We take the most difficult cases, prior failures, highest risk patients, problems that no one else will touch. Most of these are Medicare patients. With the 10.6% cut that went into effect last week (the cut did go into effect, they are only holding payments to see if it will be reversed, the cut still stands) we can no longer afford to see new Medicare patients. It was a heart wrenching decision for us, but we just cannot do it. Our staff (4 docs support 20 staff) is wonderful, we have to pay their health insurance, dental, eyes, pension/profit sharing, 401K, etc.; we have to pay increasing malpractice insurance costs; it costs us more for a needle and syringe; fiberglass casting material just went up by $1 .00 per box due to gas prices, we use multiple boxes per day.
Therefore, we have finally to make a stand and not accept the cuts. I do not know what will happen, I love what I do, I am good at it, and I really have no other skills! However, as a group we cannot operate "in the red" as there is no way to get out of debt in this type of situation.
Thank you for listening,
Lisa DeGnore, M.D.
From Lexington, KY, 07/09/2008
I am a physician in Lexington, KY. I caught the short mention of the Medicare 10.6% cuts on the air this morning. Lexington has one of the lowest Medicare reimbursement rates in the country (did you know it varies widely?) and yet we have one of the sickest populations. Over the past 5 years we have absorbed more than 20% cuts in Medicare, and over 30% decrease in commercial insurance reimbursement. Anthem/BC/BS just came to us with another 10% cut.
As physicians, our salaries have decreased dramatically. We are well below the national average for our specialty (orthopaedics) and have sacrificed our income to pay the staff cost of living raises. We face the same huge malpractice premiums as does the rest of the country, we have $4.15/gal gas, we pay more for everything, every day. It is astoniishing that Medicare and insurance companies think that we can absorbe more cuts. What other industry gets paid less every year, doing more work?
The Rep. side of Congress wants to keep the Medicare Advantage program. It is a huge rip-off for patients. Doctors tried to warn that this would not be cost-effective, but the insurance lobbies were louder. We watched Humana and others go to the Medicare administration and offer to "manage" medicare patients, if they were paid 120% of the normal medicare reimbursement. This represented a $7,000,000,000.00 windfall for the insurers. Unfortuantely they did not improve the Medicare system, they just added a layer of cost, and kept it as profit. Most Medicare Advantage programs are very confusing for patients, they offer no improvement in care, and few doctors will accept these patients, as the insurers are offering 95% of the normal reimbursement. One insurer offered our group a Medicare Advantage contract, we would have to pay them $5000.00 to join, and then they would pay us at 85% of the Medicare rate????????? We declined.
Our group is made up of very dedicated sub-specialists. We are the Orthopaedists that all other Orthopaedists refer to. We take the most difficult cases, prior failures, highest risk patients, problems that no one else will touch. Most of these are Medicare patients. With the 10.6% cut that went into effect last week (the cut did go into effect, they are only holding payments to see if it will be reversed, the cut still stands) we can no longer afford to see new Medicare patients. It was a heart wrenching decision for us, but we just cannot do it. Our staff (4 docs support 20 staff) is wonderful, we have to pay their health insurance, dental, eyes, pension/profit sharing, 401K, etc.; we have to pay increasing malpractice insurance costs; it costs us more for a needle and syringe; fiberglass casting material just went up by $1 .00 per box due to gas prices, we use multiple boxes per day.
Therefore, we have finally to make a stand and not accept the cuts. I do not know what will happen, I love what I do, I am good at it, and I really have no other skills! However, as a group we cannot operate "in the red" as there is no way to get out of debt in this type of situation.
Thank you for listening,
Lisa DeGnore, M.D.
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