November 11, 2003

Dear Editor:

As Congress continues to debate the best way to "fix Medicare," much of the focus has been on providing a prescription drug benefit. Meanwhile, Congress and the media have largely ignored a separate Medicare issue that may deprive millions of seniors of the care they need, regardless of their prescriptions.

Under the current Medicare structure, payments for medical services provided to Medicare patients will be cut by 4.5 percent, starting January 1. Those same rates were also cut by 5.4 percent two years ago, and saved from further cuts last year only by Congressional action. Because of a poorly designed reimbursement formula, Medicare reimbursement rates are computed based on the U.S. gross domestic product (GDP), and not on the actual cost of providing care.

Medicine is like any other business – if Medicare pays physicians less than it actually costs to treat those patients, physicians will not be able to afford to treat Medicare patients. Patients in underserved urban and rural areas will be greatly affected, as family physicians are often the only source of care for Medicare patients.

Without question, Medicare patients need a prescription drug benefit. Just as importantly, our seniors need a guarantee that they will have physicians in their communities to care for them now and in the future. Whatever Congress does to improve the Medicare system, it must also fix the flaws in the reimbursement formula to ensure that seniors continue to receive the medical services they need beyond their medications. The House version of Medicare reform is the only one that addresses the reimbursement formula. It's only a temporary solution, but at least it would allow time to enact a permanent fix.

Congress needs to act and pass these meaningful reforms before they adjourn.

Sincerely,

Michael Brummer, MD
Effingham, IL
President, Illinois Academy of Family Physicians

For verification contact Ginnie Flynn, manager of public relations

Illinois Academy of Family Physicians
4756 Main St. Lisle, IL 60532
630-435-0257 x118 phone
630-435-0433 fax or
gflynn@iafp.com e-mail.