 |
||||||||
 |
|
|||||||
|
||||||||
|
 |
Young doctors may avoid Fla.
© St. Petersburg Times WASHINGTON -- Seniors with high prescription drug bills are not the only folks who have been disappointed by Congress' failure to enact Medicare reforms this year. Doctors, hospitals, nursing homes and home health care providers are still waiting for the financial help they were promised by both Democrats and Republicans. The problem is this: Medicare reimbursements for health care providers are being cut at the same time that medical costs are soaring. Practitioners who treat Medicare patients feel like they are being squeezed between these competing forces. In the coming week, members of the Senate will try to agree on legislation offering some assistance to physicians and other providers who depend on Medicare funds. But Majority Leader Tom Daschle, D-S.D., says chances a bill will be passed are 50-50. Florida could be the biggest loser if this legislation is not enacted before Congress adjourns this month. With its large senior population, the Florida health care system is naturally more dependent upon Medicare funds than those in other states. The American Medical Association, which represents doctors, estimates that Medicare payments to Florida physicians will drop 12 percent during the next three years if the law is not changed. This would be on top of a 5.4 percent cut in payments during the current year. "That has caused a crisis in Florida, particularly in trying to recruit doctors to the state," said Rep. Karen Thurman, D-Dunnellon. A member of the House Ways and Means health subcommittee, Thurman has discussed this problem with many physicians in her district. Although private insurers are clamping down on physician expenses, the cuts in Medicare reimbursements far exceed such moves in the private sector. Therefore, patients with private insurance are now much more attractive to physicians than those covered by Medicare. Thurman explained: "I am hearing this from doctors who are at a point where they want to retire, maybe not immediately, but they want to bring somebody into their practice who can take over. And the young doctors, who are just getting out of medical school, are asking the older doctors in Florida, "What is the percentage of your Medicare practice?' " And when they learn that it is 65 percent, the young doctors are saying, "Oops, sorry. We can go someplace else where it is only 45 or 50 percent from Medicare, with the rest being private insurance.' " The AMA agrees with Thurman. "Losses in Florida would be the highest of any state in the country," said an AMA analysis of the consequences of falling reimbursements for physicians. Nearly 60 percent of Florida's family physicians are aged 50 or older, according to the AMA. That means if Florida doctors cannot recruit younger physicians to assume their practices, there are going to be patients -- both young and old -- searching for someone to treat their illnesses in the years to come. Nor are the problems related to Medicare reimbursements confined to doctors. Nursing homes took a 10 percent cut in Medicare reimbursements, effective Oct. 1. Hospitals and HMOs are also seeking improved reimbursement from Medicare as part of the legislation pending in the Senate. Most of these cuts in Medicare reimbursements are a result of a law Congress passed in 1997 designed to provide a balanced federal budget. The legislation allowed generous increases in Medicare reimbursements in the late 1990s, but now it is yielding large cuts. Several months ago, the House approved about $30-billion in so-called "give-backs" for health care providers that would have limited their losses during the next 10 years. But it was part of the legislation that included a prescription drug benefit for Medicare patients, and the Senate never passed a similar bill, so hopes for a solution are dim. Sens. Max Baucus, D-Mont., and Charles Grassley, R-Iowa, recently offered a substitute measure in the Senate that would include $43-billion in give-backs for providers without a drug benefit for seniors. This legislation may be debated in the Senate later this week, if the Iraq issue can be resolved quickly. But strong political forces are working against the give-backs. Several senators, including John Breaux, D-La., and Olympia Snowe, R-Maine, are committed to blocking the give-back bill because it does not include a prescription drug benefit. And the Bush administration is lobbying for more modest give-backs than Congress is likely to approve. Most lawmakers agree that Medicare needs to be fixed in many ways. Prescription drug benefits for seniors and dependable reimbursements for providers are just two of the problems inherent in this program as it tries to care for more people with less money. Yet Congress seems unable to fix even the smallest of these problems. "The people have a right to be mad at Congress," Thurman said.
 © 2006 • All Rights Reserved • Tampa Bay Times
490 First Avenue South • St. Petersburg, FL 33701 • 727-893-8111 
|
|
Times columns today Howard Troxler Ernest Hooper John Romano Gary Shelton Sara Fritz |
