[Congressional Record (Bound Edition), Volume 149 (2003), Part 18]
[House]
[Page 24258]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    MEDICARE PHYSICIAN REIMBURSEMENT

  The SPEAKER pro tempore (Mr. Porter). Under a previous order of the 
House, the gentleman from Georgia (Mr. Gingrey) is recognized for 5 
minutes.
  Mr. GINGREY. Mr. Speaker, I rise today to call attention to the 
decline in Medicare reimbursement for physicians. Effective January 1, 
2004, physicians and other providers paid pursuant to the Medicare 
physician fee schedules face at least a 4.2 percent cut in 
reimbursements. For nearly 40 years, Medicare has provided necessary 
health care to millions of patients across this country. Another steep 
cut in reimbursement rates is now forcing many physicians who provide 
for Medicare patients to make difficult choices.
  We only need to look at this chart, compare in 2004 Medicare payment 
for the various types of Medicare providers to understand the 
physicians' plight. Reimbursements for outpatient services up 3.8 
percent. Inpatient services up 3.4 percent. Payment for inpatient 
rehabilitation up 3.2 percent. Likewise, payments to skilled nursing 
facilities up 3 percent. Then we come to our physicians, down 4.2 
percent.
  Interestingly, payments to all of these other providers are going up 
and payments to physicians are getting cut again.
  Opponents to increase funding for physicians' payments often cite the 
high participation level in the Medicare program as evidence that 
physician reimbursement rates are at least adequate. True, most 
surgeons and doctors continue to treat some Medicare patients even as 
rates continue to fall. It is difficult for physicians to sever long-
standing relationships with their patients. Having practiced OB-GYN for 
27 years, I can tell you that the bond between doctor and patient is 
truly unique. It is a difficult relationship to be forced to end.
  On the other hand, I would invite you to take a look at the number of 
physicians accepting new Medicare patients into their practices. As 
more and more doctors curtail the time they devote to Medicare 
patients, seniors and disabled patients will wait even longer to visit 
a specialist. Moreover, they will struggle to find physicians available 
for referrals for follow-up chronic care.
  The problem associated with decreasing reimbursements is especially 
acute within the surgical community. The number of physicians who elect 
to practice surgery is going down. Many variables enter into a medical 
student's choice of speciality. Among these factors is the viability of 
maintaining a practice. As reimbursements decline, so too do the number 
of applicants wishing to pursue surgery. Never are the consequences 
more dire than for trauma patients in underserved areas. The inability 
to sufficiently staff hospitals in emergency situations is one of the 
ripple effects of cutting physician reimbursements.
  One of the greatest achievements of the Medicare program is the 
access to high-quality care it has brought to the Nation's senior and 
disabled patients. This level of access cannot be expected to continue 
uninterrupted in the face of continued Medicare cuts and ballooning 
liability premiums.
  Mr. Speaker, we must stop, we must stop the 4.2 percent Medicare 
physician payment cut. Help our doctors help those who need care the 
most. Mr. Speaker, we must not forget, we must never forget that 
doctors are the linchpin of the Medicare program. It will do no good to 
provide a prescription benefit for our seniors, a $400 billion plan, 
which I am very much in favor of, if we have no physicians willing to 
accept Medicare patients and write those prescriptions because of these 
continued Medicare payment cuts.

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