Tulsa World: Medicare funding worries doctors

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Medicare funding worries doctors

By KIM ARCHER World Staff Writer & JIM MYERS World Washington Bureau
Published: 7/1/2008 2:04 AM
Last Modified: 7/1/2008 2:17 AM

Congress failed to block a 10.6 percent cut before leaving for break.

Tulsa-area doctors are wondering if this might be the first year since 2002 that Congress won't intervene to avoid a cut to Medicare payments to doctors, since lawmakers failed to pass legislation before leaving for their July Fourth recess.

The Bush administration said Monday it will delay Medicare payments to doctors for 10 business days to give Congress time to reach a deal to block the cut.

If the 10.6 percent cut had taken effect as scheduled Tuesday, local doctors said it would have further reduced access to medical care for those on Medicare.

"Unfortunately, in the last 10 years, costs have not gone down 10 percent," said Dr. Lee Schoeffler, a Tulsa ophthalmologist and president-elect of the Oklahoma State Medical Association. "A lot of physicians will limit the number of Medicare patients they will see."

Even without the cuts, Medicare reimbursements to doctors have remained relatively flat in the last decade, said Dr. David Griffiths, a Tulsa family practice physician and OSMA's vice chairman of the board of trustees.

"Our actual reimbursement now is less dollar for dollar than it was in 1996. How can you afford to be paid what you were paid 10 years ago?" he said.

Under a program adopted by Congress a decade ago to limit Medicare spending, a formula automatically adjusts the Medicare reimbursement rate paid to physicians each year. Last Tuesday, the House approved a bill

that would actually raise the rate by 1.1 percent. That bill stalled in the Senate Thursday and a weeklong congressional recess began Friday.

President Bush threatened to veto the bill as it stood last week because it proposes to offset those savings by cutting reimbursements to privatized Medicare Advantage plans.

But the freeze in Medicare payments gives new impetus for lawmakers to work out a deal after the recess. And administration officials continued to express a desire to work with Congress to avoid the cuts.

That was behind Health and Human Services Secretary Mike Leavitt's move to instruct contractors not to process any claims for the first 10 business days in July.

"We urge Congress to move quickly when it returns from the Fourth of July recess to pass a bipartisan bill that the President can sign," Leavitt said Friday.

It was a statement echoed by Sean W. Voskuhl, associate state director for advocacy for AARP Oklahoma.

"Let's keep Medicare fair for everyone," he said.

Sen. Jim Inhofe, R-Okla., insisted Senate Democrats were to blame.

"Despite knowing that their bill was doomed from the start, Democrats still refused to allow consideration of a Republican alternative," Inhofe said. "Both bills provide the same update to physicians, a 0.5 percent increase for this year and a 1.1 percent increase for 2009."

He said the Republican alternative would do more for rural Americans, adding it not only preserves Medicare Advantage coverage but also expands rural health programs.

Inhofe blamed election-year politics for what he called an irresponsible delay.

Sen. Tom Coburn, R-Okla., who is a doctor, declined to comment.

Reps. John Sullivan, R-Okla., and Dan Boren, D-Okla., said they voted for the bill last week because of the impact the cut in Medicare payments would have on seniors.

"These payment reductions will result in hardships for our nation's seniors who depend on Medicare for their health coverage," Sullivan said.

Boren said the proposed adjustments in the Medicare Advantage program were necessary to ensure that all plans are receiving fair payments for the services they offer.

Some 530,000 Oklahomans rely on Medicare for their health benefits.

Of those, 45,000 are enrolled in Medicare-managed care plans, and the remainder receive traditional Medicare benefits, said Tony Salters, regional spokesman for the Centers for Medicare and Medicaid Services' Dallas office.

No matter what happens in Congress, local doctors still worry.

Griffiths, the Tulsa physician, said he doesn't expect an overnight crisis due to the rate cut.

"Tulsa's always been very gracious when it comes to these things," he said. But he first expects older doctors to retire sooner.

"I think they will say, 'To heck with this, I can't keep my doors open.' "

Then, more local physicians will seek a "better mix of patients," he said. "We all enjoy taking care of our patients, but it's about keeping the doors open," he said.

Most private insurance companies will begin reducing their reimbursement rates to doctors because they use Medicare as a benchmark, Schoeffler said.

"It doesn't hit just Medicare. It works its way down into every part of the community," he said.

Kim Archer 581-8315, Jim Myers (202) 484-1424
, jim.myers@tulsaworld.com By KIM ARCHER World Staff Writer & JIM MYERS World Washington Bureau

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	Report Comment Tony G, (7/1/2008 7:16:53 AM) I believe many doctors have been abusing medicare and medicaid for quite a while. I have heard of many unnecessary surgeries done on the elderly, and nursing home patients. Right now--health care is a disaster--and most people are just one accident away from bankruptcy. Something MUST be done to make doctors affordable--and I don't think insuring everyone is the correct course, since insurance only pays 80%
	Report Comment OKLA, (7/1/2008 9:16:14 AM) The medical community has been on a course of pricing itself out of the market for years. Since the 70's if not earlier, they have consistently raised their prices by 15% annually, regardless of the fact that inflation was much less. This has included the pharmaceutical companies, hospitals, medical equipment companies and doctors themselves. Is it any wonder that sooner or later, somebody has to say "Enough!". Not every physician deserves to make hundreds of thousands of dollars per year.
	Report Comment Graychin, Eucha (7/1/2008 10:06:34 AM) Actually, the Medicare program works very well. You pick your doctor, you get your care, and Medicare picks up a big part of the cost. It's much easier to receive care through Medicare than it is through penny-pinching for-profit insurance companies and HMO's. If this is Big Brother, bring it on! Is it really "popular opinion" that Medicare is free? You must be hanging with some really dumb people, Alden. No one believes that! Shop around for your Medicare supplement policy and the costs aren't too bad. The supplement policies are standardized so you can easily compare coverage and price. (Big Brother at work again!) But as for Bush suspending all Medicare payments: If I were a doctor, I would rather have 90% of something than 100% of nothing. How will the doctors even pay their rent if their cash flow is cut off while Bush and the Congress argue with each other? With Bush, it's all about saving the ridiculous "Medicare Advantage" program because it fits into his "for profit" religion. The only "Advantage" is to his buddies in the insurance industry.
	Report Comment Mar, (7/1/2008 10:27:26 AM) I always thought once old enough for Medicare it was free, until my mom was very ill with colon cancer. Which brings the question, since Medicare is deducted out of our paycheck while working, (I'm 59 so I'm not old enough to be on Medicare), why do people when they are on Medicare have to pay for it, when Medicare was deducted our of their paychecks?
	Report Comment debra, (7/1/2008 11:43:32 AM) Medicare reimbursements have historically been the benchmark of the insurance company to make their reimbursements on everything from surgeries, pharmacueticals, equipment, home health, etc. Once you have the filing system down, it pays within days, which is must faster than private insurance companies. Personally, I believe the insurance industry and health care industry has price fixed costs. They all agree to pay within a specific range and you do not dare charge less and bring down the payments.
	Report Comment debra, (7/1/2008 2:54:20 PM) We go to the Indian Hospital and Clinics. The care we receive is excellent. If you have insurance, then the Indian Hospital and Clinics bill your insurance. If you cannot afford the difference then the Indian Nation pays it. The Indian Nation is a prototype of universal health care and I do not see an issue with it. Personally, if you have Medicare, private insurance, or Medicaid then you should remain with those, but for those that can not get insurance something must be done now. Something similar to the Indian Nation Health care would be very helpful for this portion of our citizens.
	Report Comment lingham, cuming (7/2/2008 9:00:31 AM) MY NAME IS LINDA, i BELIEVE THAT DOCTORS HAVE ABUSED THE MEDICARE SYSTEM, THATS WHY THE MEDICARE IS IN A MESS, WE DO NOT WANT INDIAN DOCTORS OR THE HEALTH CARE SYSTEM THEY HAVE. i AM NOT RECOVERING FROM A MISTAKE THAT AN INDIAN DOC MADE ON ME WAS SUPPOSED TO BE A SIMPLE TEST THE DOCTOR PUNCHED A HOLE IN MY COLON I SPENT ONE WEEK IN HOSPITAL, OUT OF WORK FOR OVER A MONTH DOCTOR HAS NO REMORSE THE HOSPITAL BILL IS OVER 30 THOUSANDS A SURGON HAD TO REPAIR I DO NOT KNOW THE COST OF THAT BUT MY INSURANCE COMPAY WILL PAY i HAVE BLUE CROSS BLUE SHEILD i WORK SO I AM NOT ON MEDICARE I AM 66 YEARS OLD . CAN NOT SUE THE DOCTOR HE IS PROTECTED BY THE LAW NEW LAW CAN NOT SUE DOCTOR FOR MALPRACTICE . THE DOCTOR COULD SEE I HAD A KINK IN MY COLON BUT PRCEEDED WITH THE TEST HE WANTED THE MONEY . DO NOT GET INDIAN, OR OTHER OUT OF COUNTRY DOCTORS THIS COUNTRY NEEDS TO GET OUT OF THE WELFARE SYSTEM HEALTH CARE AND ALL. THE CLINTONS AND WORSE OF ALL WILL BE OBOMA, THE COMMUNIST. TO RULE OUR HEALTH CARE AND OUR LIVES LETS WAKE UP AMERICA.
	Report Comment Nunya, (7/2/2008 7:44:36 PM) people are dying in waiting rooms. did ya see the video of that poor woman in new york falling to the floor in the waiting room and lay there for an hour and left to die !!! the parties who ignored her. they will never be able to face the public. hopefully their neighbors and relatives will shun them forever. hopefully they will be tried for murder! check out the video at cnn.
	Report Comment TCC, Milwaukee (7/7/2008 8:53:41 AM) To limit health care to the elderly based on a few doctors abusing the system is wrong. It is more moral to go after the abuse and not punish the law abiding citizens by limiting their health care. Yes the system needs to be fixed, but the real crime is the capitalistic approach we take to health care and the greed it supports at the expense of our nation's health. We spend the most on health care in the civilized world, yet we are ranked number 39 in actual health, a disgrace. To paranoid racist Linda who wants to blame everything on Indian doctors, give me a break! Indians are way ahead of the curve on the healing arts, and we are just amateurs. I prefer non-American doctors to American's who just want to chop and medicate, because they know nothing else.
	Report Comment bethany, tulsa (7/8/2008 9:51:21 AM) I have worked in the medical community for some years. 95% of doctors out there are good and want to do the right thing for patients, they want to heal, but just like anybody they need to make money, they have choosen this as there job, so of course it is about money. Most doctors are small business owners, there overhead is outstanding. The cost for staff, equipment, medication, etc. it makes it very hard to come out in the black. If they are getting cut in pay they will stop taking those patients, you are going to find more and more doctors not taking medicare patients, if they don't have the money for proper equipment or medications to treat, what kind of doctor would they be. Besides the fact if you went to school for 10-15 years, wouldn't you think you deserve to make good money.

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