Medicare payments to doctors to be slashed; AMA panics as more doctors drop Medicare patients

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The 2007 reduction is part of a plan to cut physicians' fees by 40 percent over the next nine years, and while Congressional and Bush administration officials admit the cuts are not really feasible, and Congress has been willing to postpone the cuts in the past, its willingness has seemingly run out.

This turn of events has frustrated the AMA, leading to a nationwide campaign to persuade Congress to cancel the cut, and organizers hope to spur the lawmakers to act before they adjourn for reelection campaigns in October. Unfortunately, aides to key representatives and senators have reported that action is unlikely due to other priorities and the truncated schedule, and the Bush administration has made no moves to defer the cuts.

"The real financial problem with health care is not who pays or how much they pay," explained Mike Adams, a consumer health advocate and author of several books on health, "it's a question of preventing disease in the first place so that expensive health care services are no longer needed. This can be easily done through nutrition, public education, banning junk food advertising and even outlawing direct-to-consumer drug ads that clearly harm the public," he said. "But our government regulators, which are in bed with powerful corporations that profit from continued disease, refuse to take any meaningful action to actually prevent disease."

It is projected that Medicare will pay doctors about $60 billion in 2007 under the current fee schedule, which has led to rising fees due to the volume and complexity of services now available in doctors' offices. However, studies show more money does not necessarily translate into better health care.

In 2004, Dartmouth College health economists released a report that stated New Hampshire had the highest ranking in overall health care quality, and spent about $5,000 per Medicare beneficiary. Conversely, Louisiana spent $8,000 per beneficiary and had the lowest ranking.

Herb Kuhn, head of the Medicare division that deals with healthcare providers, said that the old system that pays doctors for numbers of office visits, tests and procedures is no longer appropriate, and should be replaced with one that rewards doctors for quality care.

"To throw more money into this old system is not the right answer, Kuhn said. "We need to work together to find a better and more appropriate way to pay."

The AMA has been working with Medicare to come up with ways to measure quality of care to be the basis of such a payment system, but while some medical specialty societies have come up with points of reference, other groups have been slow to respond.

"It is probably fantasy to think that we are going to be able to create a quality program in the next 30 days that is going to solve Medicare's problem," said AMA board member, Dr. William A. Hazel Jr., an orthopedic surgeon in Herndon, Va. "Absent that, we need to get the payment problem resolved.

"The predicate for having a quality system is to have enough funding in the system for physicians to be able to afford to practice," he added. "We can't take the hit now and be expected to offer better services."

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