Medicare cuts worry doctors Metro physicians say six-year reduction plan will force them to drop patients and services.

1. Medicare cuts worry doctorsMetro physicians say six-year reduction plan will force them to drop patients and services. Sharon Terlep / The Detroit News September 4, 2004

2. Medicare Cuts RIVERVIEW -- Dr. E. Chris Bush worries he may have to start turning prospective patients away from his small Downriver practice if the federal government goes ahead with plans to reduce Medicare payments to doctors. Bush is among a growing number of physicians who say the proposed cuts may leave them little choice but to accept fewer elderly and disabled Medicare recipients. At issue is the federal government's proposal to reduce payments to doctors through Medicare by about 4.3 percent next year. Cuts would continue over a six-year period. "If we're losing money on each visit, it wouldn't make sense to continue at the same pace," Bush said from his office where about half of the 30 patients he sees daily receive Medicare.

3. Physicians� Costs Bush has watched his insurance premiums skyrocket and costs for everything from paper towels to prescription drugs balloon. Meanwhile, many of his fellow family doctors have cut employees, scaled back services and limited the number of new patients they'll take. The case that Bush and doctors' groups throughout the nation are making is one of basic business: Pay us less, and expect less in return. Others say the doctors' warnings ring hollow and most couldn't afford to turn away Medicare patients. At stake in the debate is the health care of 42 million Americans, including 1.5 million Medicare patients in Michigan.

4. Stop Taking New Patients? The cost of treating patients is rising fast while reimbursement rates have barely inched up, creating a widening gap, said John Armstrong, a Florida doctor and member of the board of trustees with the American Medical Association. An association survey predicted that 38 percent of physicians will stop taking new Medicare patients if the reimbursement cuts take effect Jan. 1. Many, however, aren't buying the doctors' argument. Some patients don't want to see physicians' payments increase if it means higher premiums. Medicare (Part B) premiums are $78.20 per month this year, an increase of $11.60 over 2004. Rates are expected to increase more than 14 percent next year.

5. Economics Managed Care and Medicare put an end to downward sloping demand.

6. Economics If Medicare reimbursement falls, then what happens?