September 13, 2006
Sent via e-mail to Ed Koziarski,
Director of Editorial and Commentary
Written by Peter E. Eupierre, M.D.,
President of the Illinois State Medical Society
Re: Shortened Column for the Chicago Daily Southtown
Act Now! Your health care shouldn’t rely on the health of the economy
As a physician, I’ve witnessed a lot of change in the Medicare program over my twenty-six years of medical practice, including the recently expanded drug coverage for senior citizens under Medicare Part D. Although my most vulnerable patients now can better afford the medication they need, I’m concerned that I may not always be able to find them the care they need if Congress doesn’t fix Medicare’s antiquated reimbursement formula for doctors.
For instance, did you know that whether doctors can afford to treat our senior citizens is legally tied to how healthy the U.S. economy is each year? Several years ago, Congress developed a complicated formula, based on several economic indicators, for reimbursing doctors called Sustainable Growth Rate or “SGR.” Thanks to the shortsightedness of SGR, if Medicare patients’ medical care exceeds the growth rate of our economy, physicians receive a Medicare reimbursement cut. Currently, the federal government is predicting a 5.1% pay cut to doctors in 2007.
What do these cuts mean for our community? A 5.1% annual cut may not sound like a lot, but I can assure you that the cost adds up over time. Medicare payments to Illinois physicians and health care professionals will be slashed by $120 million in 2007. But over the next nine years the cuts will snowball to total $7.6 billion in Illinois. That means that the government will reimburse about $5,000 less in medical services per Medicare patient through 2015. Doctors aren’t the only group saying the current reimbursement methodology to physicians is flawed. Even Medicare itself acknowledges the current formula should be replaced with one that “provides a better support for quality care and efficiency.”
So why is patient use of Medicare services outpacing economic growth? New medical and drug breakthroughs, as well as congressional expansion of Medicare coverage for screening and imaging tests, are all factors. Today, Medicare patients have access to the best technology medicine has to offer and are subsequently living healthier and longer lives. But this technology comes with a price. If Congress doesn’t act soon, physicians will have to bear more and more of these costs.
My physician peers and I worry daily that we’ll be forced to limit the number of Medicare patients we see due to these cuts. No matter how low our Medicare reimbursement rates become, the medical equipment vendors and utility companies with whom we do business still expect us to pay their full costs, and we still have to pay our office staff’s salaries and benefits. Some of us are already planning to curtail our practices once the upcoming cuts become effective. In a recent AMA survey, 45% of physicians said that next year’s projected cuts would force them to decrease or stop seeing new Medicare patients.
Please believe me, doctors DO NOT want to stop taking care of our nation’s senior citizens, but we need your help to urge Congress to fix the flawed Medicare reimbursement formula. Fortunately, time remains for Congress to pass legislation to stop this year’s proposed cut and to fix the flawed formula that ties your health to that of the economy’s. Please contact your members of Congress and let them know how important it is to maintain access to Medicare services for our senior citizens.
Dr. Peter E. Eupierre is an internal medicine specialist from Oak Brook, Illinois and is President of the Illinois State Medical Society. The Illinois State Medical Society is a professional membership association representing over 14,000 physicians practicing in all specialties statewide.
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