AMA: some physicians would have dropped their patients

The Senate may have averted a Medicare predicament on Wednesday.

Over the fiscal objections of Sen. Jim Bunning, R-Ky., the Senate passed a sweeping bill that cleaned up a host of unfinished congressional business from last year, including extending unemployment benefits.

The bill prevented doctors from absorbing a 21 percent cut in Medicare payments.

If Congress enacts and President Obama signs the bill, it will be the third time in four months that lawmakers have delayed the Medicare pay cut of 2010. The reduction - triggered by the sustainable growth rate formula that Medicare uses to set physician reimbursement - was originally scheduled to take effect Jan. 1. However, Congress voted last December to delay it until March 1.

Lawmakers followed up with a second extension to April 1. Now the cut is delayed until Oct. 1.

For 32,200 seniors in Highlands County - about 52,000 in the winter - this was a vote that mattered. It was also important to a sizeable community of doctors and nurses, technicians and therapists, hospitals and clinics.

"It's been a problem for years and years," said John Neuman, a retired M.D. from Michigan who now lives in Tanglewood. "I don't know why they always want to pick on doctors."

By the time he retired 10 years ago, the Medicare administration had reduced fees so much, Neuman said, "I would have to take $2 or $3 out of my pocket for every Medicaid patient I treated." He offered to treat Medicaid patients for free, but the state declined, saying paperwork was needed.

The American Medical Association sent a press release saying that doctors were "outraged" with the 21 percent cut, which could still happen later this year. The AMA quoted several unnamed physicians:

"As a practicing psychiatrist in D.C. for over 35 years, I have always treated Medicare patients for the Medicare fee, which is already way below the standard fee for my services. I felt this was an obligation to take care of senior citizens. At this point, unless this 21 percent reductionin fee is repealed, I will have to abandon seeing Medicare patients. I will have to do this with a heavy heart, as I will not be able to maintain my practice at these rates.Given the expenses of maintaininga practice where all costs escalate every year - malpractice, licensure, CME credits, rents, administrative fees, etc. - it no longer becomes feasible to sustain the practice."

Florida Hospital Heartland Chief Financial Officer Dima Didenko was also concerned, but he didn't think local doctors would abandon Medicare clients.

The hospital is required by law to take Medicare and Medicaid patients, but even if that wasn't the case, both Didenko and the hospital feel a Christian obligation.

"That's 56 percent of our patients," he said. Local physicians would see similar percentages, he thought, with the exception of specialists like pediatrics.

"It's their bread and butter," Didenko said.

The hospital employs 24 physicians and attempts to break even with their billings, Didenko said.

Instead of cutting Medicare reimbursements, the government should combine the federal and state Medicare and Medicaid programs into a national health care plan, Neuman offered.

"The government thinks that every doctor is a millionaire," Neuman said. "There's a hell of a lot more millionaire lawyers than doctors."