When Medicare Cuts Fees, Patients Suffer


Fewer Doctors, Less Care, Less Time, NCPA Study Says

DALLAS (October 22, 2002) -- As Congress debates whether to keep proposed cuts in the fees Medicare pays doctors, a study by the National Center for Policy Analysis (NCPA) says that low physicians' fees result in less access to doctors and reduced quality of care for the nation's elderly.

"The government thinks it is squeezing doctors, but seniors are the ones who are really getting squeezed," said Greg Scandlen, NCPA Senior Fellow.

According to the report, the fees Medicare pays physicians are not determined in the marketplace. Instead they are set by the Centers for Medicare and Medicaid Services (CMS), based on a complex formula. When fees are cut, doctors respond by spending less time with patients, refusing to accept new patients, cutting back on the purchase of new equipment and reducing amenities.

The NCPA analysis cites an American Medical Association (AMA) finding that many physicians who treat a significant number of Medicare patients are already limiting seniors' access to their services and that the situation will only get worse if the cuts continue. For example:

  • Almost 30 percent of physicians limit the number of new Medicare patients they will accept - or do not accept Medicare patients at all.
  • 47 percent of physicians are spending less time with Medicare patients during a visit and are squeezing more visits into each working day.
  • More than 38 percent of doctors and close to half of all surgeons have delayed purchasing new equipment.

By 2005, Medicare patients may have access to little more than half of all physicians. Even those who treat Medicare patients may not accept new patients. Reduced access means longer waits. According to a survey of seniors by the Center for Studying Health System Change (HSC):

  • More than one-third of seniors in 2001 reported having to wait more than three weeks for an appointment for a checkup - up 15 percent from 1997.
  • Over 40 percent of seniors waited more than a week for an appointment to treat a specific illness - up 16 percent from 1997.

"Government fee-setting is not helping seniors," said Scandlen. "What the elderly need is access to the same kinds of health plans the non-elderly have."