[Congressional Record (Bound Edition), Volume 149 (2003), Part 19]
[House]
[Pages 26007-26008]
[From the U.S. Government Publishing Office, www.gpo.gov]




                HOW IS A SURGEON TO SURVIVE IN BUSINESS?

  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 again this week as I have done in 
previous weeks to call attention to declining Medicare reimbursement 
for physicians. Effective January 1, 2004, physicians and other 
providers paid pursuant to the Medicare physician fee schedule face at 
least a 4.2 percent cut in reimbursements.
  For nearly 40 years, Medicare has provided necessary health care to 
those millions of patients across this country. Another steep cut in 
reimbursement rates is now forcing many physicians who care for 
Medicare patients to make very difficult choices. Complicating the 
situation, Mr. Speaker, further, is the fact that doctors in some areas 
are experiencing double and even triple-digit percentage increases of 
their liability premiums. In a host of States, like my State of 
Georgia, surgeons are scrambling to find affordable liability 
insurance, if it is available at all.
  When doctors are forced out of practice, patient access to care is 
further compromised. Fewer doctors overall translates into greater 
difficulty obtaining an appointment for every patient but especially 
those who rely on Medicare.
  Earlier this year we passed H.R. 5, the HEALTH Act to combat the 
problem of increased liability premiums at the Federal level. 
Unfortunately, this commonsense legislation has now languished in the 
Senate. I reiterate my support for this bill, and I urge its swift 
passage by the entire Congress so that President Bush can sign it into 
law this year.
  Until that time, however, one of the main costs of running a medical 
practice for many high-risk specialists, including general surgeons, 
will continue to be liability insurance. Looking at this chart, you can 
easily see that increases in liability premiums have grossly outpaced 
Medicare reimbursement.
  Using information collected by the independent trade publication 
Medical Liability Monitor, this chart compares the average liability 
premiums for general surgeons to the Medicare physician payment update. 
In 2001, physicians received a 5.1 percent Medicare payment update. 
During that same period liability premiums increased 14.6 percent. Then 
the next year Medicare physician payments were cut 5.4 percent. While 
doctors are trying to manage this cut, their liability premiums spiked 
to an additional 29 percent. There is no doubt that at least with 
respect to liability premiums, Medicare reimbursement continues to fall 
far behind the cost of doing business.
  As an OB/GYN myself, I can assure you that a physician's practice is 
indeed a small business. When faced with decreasing income and soaring 
expenses, doctors cannot simply increase the cost of patient visits. To 
keep medical practices open, doctors make tough choices. Some doctors 
delay the purchase of new equipment; others reduce the size of the 
staff. Many increase the percentage of non-Medicare patients they see, 
leaving insufficient time in a busy schedule to see a sufficient number 
of Medicare patients.
  Mr. Speaker, I would like to relay a story that demonstrates just how 
the cuts in physician reimbursements are affecting medical practices in 
my home State of Georgia. Dr. Harry Sherman, former president of the 
Georgia chapter of the American College of Surgeons, has lived in 
Georgia for more than 70 years. He remembers when Congress first 
enacted Medicare. Now, about 40 percent of his surgical patients are 
Medicare.
  I recently had an opportunity to speak with Dr. Sherman at the 
American College of Surgeons annual meeting in Chicago. During our 
conversation, it became clear to me that Dr. Sherman obtains a great 
deal of personal satisfaction from treating Medicare patients.

[[Page 26008]]

  As a physician myself, I understand that unique bond that develops 
between doctor and patient, but as the cost of doing business continues 
to increase and the level of reimbursement drops, further and further, 
he admits that it influenced his decision about when to retire.
  Dr. Sherman is one of Georgia's most seasoned surgeons. He was born 
and raised in Georgia, and is truly an asset to his community and his 
patients. When continued Medicare payment cuts are forcing good 
surgeons like Dr. Sherman to retire for financial reasons, something is 
badly wrong.
  One of the greatest achievements of the Medicare program is the 
access to high-quality care it has brought to our Nation's seniors and 
disabled patients. This level of access cannot be expected to continue 
in the face of deep Medicare cuts and growing liability premiums.
  Mr. Speaker, doctors are the linchpin of the Medicare system. Let us 
not force them out of the system. Stop the 4.2 percent Medicare 
physician cut; help doctors help those who need their care the most.

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