Opinion
Primary care, rational premiums are needed to make Medicare sustainable
LETTER — Posted July 16, 2007
Regarding "AMA survey: Senior access at risk if Medicare cuts doctor pay 10%" (Article, June 18): There's no question that access for the future senior population is in peril. Perhaps more important than the number of providers who will stop seeing Medicare patients is the simple shortage of primary care providers, especially internists who will be working in the next 10 to 20 years.
The number of American-trained students looking to enter primary care is well below the available residency slots, and many of those will be women who will want to have families and not end up as full-time-equivalent providers. Nurse practitioners can help, but the complexity of most geriatric-age patients requires well-trained, experienced doctors to continue to provide the quality health care we expect and want for our population.
I think it is unethical to expect pulling physicians trained outside the U.S. to fill the gap, as many of their own countries will be facing an aging population as well.
The issue is primarily reimbursement, as most of us know. A Medicare program where the retired CEO of a Fortune 500 company pays the same premium as a country sawmill worker only begs for disaster.
David L. Chesler, MD, Charlottesville, Va.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/07/16/edlt0716.htm.
