Ethical Health Partnerships

Educate yourself, friends and family

Write and call NOW urging your senators and representatives to prevent proposed cuts in Medicare reimbursement for 2008 and subsequent years.

Points you may want to include in letters or calls:

* The effect of the cuts includes nearly all physicians and patients regardless of age because most private insurance companies, HMO's and network management companies base their reimbursement rates on Medicare, regardless of the age or insurance of the patient. As a result physician fees will be reduced even beyond the projected estimates of 40% reduction by 2015 (Medicare Trustees Report).

* Medicare and Congress need to create more ethical health partnerships with physicians and patients. The proposed cuts and the SRG (Sustainable Growth Rate) formula itself places undue burden on physician practices without regard for their rising expenses. It penalizes them for changes in the economy, the population, and goverment expansion of Medicare benefits, all of which are outside the control of physicians. That is unjust.

* Congressional leaders in both parties know that the formula (SGR) used to pay physicians needs to be replaced. It is time to fix the problem, rather than patch it. Other Medicare providers, like hospitals, are not tied to the law of Sustainable Growth Rate used for physicians. Under this formula, while Medicare plans to cut physician payment, hospital reimbursement is expected to increase 32% in the same period.

* It is essentail to protect patient access to services most deeply impacted by previous and proposed cuts, and to protect access to physicians themselves. During the period of proposed cuts, physician practice expense is projected to rise 19%. Payment for many physician services has already been reduced over the past 9 years in spite of rising practice expenses, cost of living, and malpractice premiums. Some specialties like surgery have had 20-30% reductions. In Florida, the average malpractice premium rate for a general surgeon or ob-gyn is 2003 is over $140,000 per year (up to $277,000 per year) and many other states face double digit increases in premiums. Some physicians will not be able to remain in practice with further decreases in payment for their services. (If you know of an example in your own city, use it.)

* Managing costs should be focused on high cost areas like preventing and managing chronic illnesses, drug prices, defensive medicine, and other drivers of increasing health costs. Increasing patient premiums and reducing payment to physicians is easiest to control, but has negative impact and does not fix the problem.

* The proposed cuts significantly affect physician wellbeing and ultimately can impact quality of care. Studies have shown that physician dissatisfaction and stress can contribute to lower quality of care. Neither physicians nor patients want that. Physicians have to increase volume of patients to try to make up for cuts.

* You want quality healthcare to remain available to you and other patients. This is not about party politics. You expect Congress to commit to co-creating ethical health partnerships with your physician and with you and your family.

For further reading about this issue:
My Submission to the House Ways & Means Committee Hearing on the Proposed Cuts in 2005 -- still relevant for current cuts.

Downloadable Reports and charts listed on the AMA site:
Medicare Physician Payments: The Facts (good 2 page summary)
Chart: Physician Payments vs Other Providers
Chart: Practice Costs vs Medicare Payments
Map: Medicare Payment Cuts 2007-2015
Testimony: Medicare Payment for Physician Services: Examining New Approaches
Letter: Joint Recommendations to Congress on Eliminating the SGR