opinion

Send a message to Congress: "Repeal SGR now"

A message to all physicians from Rebecca J. Patchin, MD, chair of the AMA Board of Trustees.

By Rebecca J. Patchin, MDis an anesthesiologist and pain management specialist in Loma Linda, Calif. She served as chair of the AMA Board of Trustees during 2009-10. Posted Feb. 15, 2010.

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When someone's mother cannot find a doctor, or when a soldier's children are refused medical care because the local clinic does not take military insurance, it's a family crisis.

If it becomes increasingly difficult for senior citizens or military families to find physicians who will treat them, it will be a national disaster.

And if the Senate does not act to reform Medicare physician payments by March 1, when a 21% decrease in physician payments is due to take effect, that disaster will occur.

That was the message that we, along with top representatives of AARP and the Military Officers Assn. of America, took to the public on Jan. 21. In an five-city satellite news conference, we spoke out about the pending Medicare payment crisis, not only from a physician's perspective but also from the voices of two large, respected constituent groups.

Nancy LeaMond, AARP's executive vice president, told reporters at the National Press Club: "Medicare is quite literally a lifeline. Seniors must have access to their doctors, and if they don't, they will skip getting the care they need or they will go to an emergency room, where the cost of care is extremely high."

In Norfolk, Va., Capt. Kathy Beasley, USN-Ret., MOAA deputy director of government relations for health affairs, said, "The last thing our troops in combat should have to worry about is whether their sick spouse or child can find a doctor to treat them."

During that satellite news conference, reporters also heard from North Dakota's state AARP vice president; AMA President-elect Cecil B. Wilson, MD, in Portland, Maine; and AMA Chair-elect Ardis Dee Hoven, MD, at a family clinic in Madison, Wis.

And the media listened. From National Public Radio to Fox News to the Los Angeles Times article reprinted across the country, to ABC News, the Associated Press, American Medical News and Medscape, the pickup was widespread and positive. Our message went out loud and clear: "The Senate must act before March 1 to permanently fix the Medicare physician payment problem or our seniors and military families will lose access to medical care."

The five-city satellite news conference was only the latest in the AMA's campaign to alert Americans and members of Congress about the pending crisis.

We have launched a national television commercial describing the situation and urging voters to contact their senators. View it online (link).

Additionally, in recent months:

  • AMA trustees fanned out across the country promoting the issue to physician and public audiences.
  • We sent letters to congressional leadership, urging action.
  • We held press conferences in major cities and key congressional states.
  • We met with editorial boards at major newspapers.
  • We urged concerned citizens to stay abreast of the situation by joining AMA's Patients Action Network and to let their senators know that time is running out (link).
  • We spread our message through social media networks, including Facebook, Twitter and YouTube.
  • And we are in Washington every day, pressing our point and urging members of the Senate to act quickly and to permanently repeal the sustainable growth rate formula and fix the Medicare physician payment problem.

Ironically, this situation is all too clear to the senior citizens who depend on Medicare, and military families and retirees whose Tricare health insurance payments are tied to Medicare payment levels.

Currently, about one in four Medicare patients seeking a new primary care physician reported that they had difficulties finding one, according to a survey by an independent government panel, the Medicare Payment Advisory Commission. (Incidentally, MedPAC recommended that Congress replace the pay cut with a 1.1% pay raise.)

As of Jan. 1, the primary care physicians affiliated with a Mayo Clinic facility in Arizona have stopped accepting Medicare. It has left seniors and many others asking: "If the Mayo Clinic won't take Medicare, who will?"

The irony of this untenable state of affairs is that all sides agree that the system is broken and must be fixed. We have heard that from members of both the House and Senate on both sides of the aisle.

Last fall, the U.S. House of Representatives passed a bill -- HR 3961 -- which not only would repeal SGR but also provide a 1.2% increase. The Senate, however, has failed to pass similar legislation.

The situation is clear -- and dire. If the Senate does not permanently fix the problem before March 1, those who take Medicare patients will be facing an immediate 21% cut in payments -- after a decade of payments that haven't kept up with the cost of providing care. And America's seniors, baby boomers and military families will be the losers.

If you have not yet been in touch with your senators, I am urging you to get involved now. Enroll in the Physicians Grassroots Network and find your senator's contact information at the AMA's Legislative Action Center Web site capwiz.com/ama/home/.

Explain to your senators that if the SGR is not repealed by March 1, more and more physicians will be forced to limit or eliminate the number of Medicare and Tricare patients they can afford to treat. And insist that they act now.

The Medicare Payment Action Kit on the AMA Web site even can tell you what will happen in your own state should Medicare payment reform not be passed (link).

And if members of Congress believe the uproar over health system reform has been loud and fractious, they have no idea what's coming.

Rebecca J. Patchin, MD is an anesthesiologist and pain management specialist in Loma Linda, Calif. She served as chair of the AMA Board of Trustees during 2009-10.

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