Not every doctor accepts medicare patients. Many doctors only accept a few. The same is true of medicaid patients. This is because government payments are less than the going rate for their services. This could become a problem.
The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program.
Recent surveys by national and state medical societies have found more doctors limiting Medicare patients, partly because Congress has failed to stop an automatic 21% cut in payments that doctors already regard as too low. The cut went into effect Friday, even as the Senate approved a six-month reprieve. The House has approved a different bill.
• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.
• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.
• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.
The federal health insurance program for seniors paid doctors on average 78% of what private insurers paid in 2008.
“Physicians are saying, ‘I can’t afford to keep losing money,’ ” says Lori Heim, president of the family doctors’ group.
We’ve got to cut medical expenses, we keep saying. That means doctors will get less money. But what if doctors won’t work for what we want to pay? Shouldn’t doctors, like other economic players, be able to set the fees the market will allow? Or should they be forced to serve anyone who comes into their offices?