The Medicare Access Issue

Dr. Marc Siegel, an associate professor of medicine at New York University’s Langone Medical Center, raised some interesting points in a commentary piece last week. He points out, utilizing data from the Medicare Payment Advisory Commission, that 28 percent of Medicare beneficiaries in 2008 had difficulty finding a primary care physician. That’s up from 24 percent in 2007. In his piece, Dr. Siegel told firsthand the story behind the statistics:

More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I’ve had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider — who they liked — abruptly stopped taking Medicare.

While Dr. Siegel does a good job breaking this distressing trend down to the patient level, the overall point he’s making is not a new one. In December, the nation’s hospitals and health insurers released a study, performed by the respected Milliman actuarial firm, showing that, in 2006 and 2007 combined, physicians and hospitals had to shift almost $90 billion in cost to private payers because of Medicare and Medicaid underpayments.

Dr. Siegel is telling us that a number of doctors, rather than finding ways to recover their Medicare-related shortfalls, are being forced to turn away Medicare patients. As policymakers discuss access to quality healthcare, the problem lies not only with the uninsured but also with older Americans who could have an increasingly difficult time finding a physician.