Doctors anticipate boomers will affect Medicare reform

Doctors are counting on baby boomers, that huge demographic lump closing in on retirement, to protest to lawmakers when they can't find a doctor who will take a patient on Medicare, the American Medical Association's past president said today.

Dr. William G. Plested III, a California surgeon, said a self-selecting survey of doctors nationally found that 60 percent of doctors plan to limit the number of new Medicare patients they treat if planned cuts of 10 percent in Medicare reimbursement take effect Jan. 1.

Other proposed cuts would reduce payments by nearly 40 percent by 2015, he said. "This is the problem: Physicians' payments aren't keeping pace with the costs of practicing medicine."

While reimbursements are shrinking, practice costs are rising, Plested said. Also, doctors who responded to the survey said that if the cuts go through, they would take other measures. More than half said they would defer purchasing new medical equipment and information technology, begin referring complex cases, discontinue nursing-home visits and stop outreach to patients in rural areas.

Medicare cuts don't affect just seniors, Plested said. They also affect military families and the disabled, because their health-insurance system is tied to Medicare. In Washington, the cuts could affect 336,000 military-family members and 760,000 Medicare patients, he said.

But Congress won't make any changes unless patients protest, Plested said. "That's why I'm thrilled about the boomers, because they won't take no for an answer."

Congress, coping with the Deficit Reduction Act of 2005, has threatened to cut Medicare payments before, then saved the doctors with a last-minute fix. Those cuts are now part of behind-closed-doors wrangling between House and Senate members over the State Children's Health Insurance Program bill (SCHIP).

Sens. Patty Murray and Maria Cantwell, both Washington Democrats, have decried the cuts.

Plested said the situation is potentially worse in Washington state, which has a higher-than-average proportion of Medicare patients and a lower-than-average ratio of physicians to patients.

Medicare payments historically have been low in Washington, said Tom Curry, executive director of the Washington State Medical Association, which represents the state's 9,000 doctors. Overall, one in four Medicare patients already has trouble finding a doctor who is accepting new patients, Plested said.

There are now towns and rural areas where a patient on Medicare can't find a doctor, he said. One of them is Durango, Colo., an upscale community popular with retirees, where he has a second home.

Bellingham, recently cited in a "best places to retire" article, has a similar problem, said Curry. "The article forgot to mention that if you're going to do that, you have to bring your own physician with you."

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com