Experts debate effect of expected Medicare cuts
Opponents say the cuts may force doctors to stop taking Medicare patients. Not everyone buys that dire scenario.
By JUSTIN GEORGE
Published August 9, 2005
TAMPA - For David Becker, a Clearwater gastroenterologist, a looming cut in Medicare payments next year won't hurt his business.
"Trivial," he said. "A lot of people say, "You guys are crying about your salary.' Well, I can live without 2 percent of my salary."
But for larger clinics, doctors say upcoming Medicare cuts might mean cutting jobs, especially because the cuts could add up to 26 percent over six years.
Worse, Becker said, doctors may stop taking Medicare patients because the government isn't paying enough. If seniors do get in the door, doctors will have less time to spend with them because they'll be busy seeing more patients so they can make more money.
"It'll mean a longer time to get a hold of us, a longer wait to see us," Becker said.
The American Medical Association painted this grim picture Monday at a news conference with the Florida Medical Association and area doctors to decry expected Medicare payment cuts. Becker, past Pinellas County Medical Association president, joined a small group of medical leaders to drum up publicity against the cuts, which would total 4.3 percent next year and start Jan. 1.
The effort, part of a national AMA campaign, coincided with a a full page ad in the St. Petersburg Times on Monday, picturing an elderly woman's hands and a message:
She overcame poverty. Cared for her younger sisters. Put herself through college. She shouldn't have to fight for the health care Medicare promised her.
AMA officials said the cuts in doctor payments come at a time when the cost of patient care is projected to increase 15 percent. They said 38 percent of physicians nationwide said they would have to cut the number of new Medicare patients they see in response. Twenty percent of Tampa Bay physicians already refuse Medicare patients. That would double, doctors predicted.
About 17 percent of all Florida residents use Medicare.
"In certain specialties," said Michael Wasylik, chief of staff of St. Joseph's Hospital and past Hillsborough County Medical Association president, "seniors will not be able to see anyone."
Not everyone buys into that dire scenario. Similar Medicare cuts in 2002 led to Medicare spending increases, said Alwyn Cassil, spokeswoman for the Center for Studying Health System Change, a nonpartisan research organization. That meant doctors saw more Medicare patients or saw them more frequently and continued to make money.
"You have to be very cautious when you hear about physicians talking about the hard times that have befallen them," Cassil said, adding that doctors in the retiree-heavy Tampa Bay area will have a hard time saying no to Medicare money, even if the cuts happen.
But, she said, more than one year of cuts could hurt. Cassil's center found that 2003 was the first year Medicare seniors' access to doctor services stabilized since a significant decline in 2001.
The cuts aren't caused by a bill. In 1997, Congress approved the method to determine how much Medicare should pay doctors. The scale went into effect in 1998 and factors in types of medical procedures, overhead and malpractice insurance.
The economy is tied to the formula, which is calculated annually and decreases Medicare payments if the government health system spends too much. It increases payments if Medicare isn't paying enough.
Last year, Medicare spending increased by 13 percent compared to 2003.
The AMA wants people to urge Congress to pass two bills in the U.S. House that will stop the cuts.
--Justin George can be reached at 813 226-3368 or jgeorge@sptimes.com