Medicare cuts again pose threat

Just a year ago I wrote of the potential for devastating consequences for all patients who are over the age of 65 or disabled and their physicians should scheduled cuts to Medicare reimbursement rates to physicians go into effect on Jan. 1, 2008.

Ultimately, Congress delayed the implementation of those cuts until July 1 — last Tuesday. And for the last six months the 674,000 Medicare-eligible patients in S.C. and their physicians have stood together on the edge of a precipice waiting for Congress to enact legislation that would prevent these payment cuts from going into effect at all.

Last week the House of Representatives showed great concern and compassion towards this country's nearly 44 million Medicare-eligible patients and their physicians when they overwhelmingly and in a bipartisan manner voted to stop these cuts by passing the Medicare Improvements for Patients and Providers Act of 2008 by a vote of 355-59.

We in South Carolina are fortunate that five of our six congressmen were in the majority, courageously standing up for our senior patient care, including Lowcountry Congressmen Henry E. Brown Jr. (Republican, 1st District), Joe Wilson (Republican, 2nd District) and Jim Clyburn (Democrat, 6th District).

With such a lopsided bipartisan vote in the House, it was unthinkable that the Senate would do anything different.

But in Washington, that which is obvious to us does not always translate into reality.

Last Thursday night, interested observers were able to watch the Senate debate and ultimately vote on the Medicare Improvements for Patients and Providers Act of 2008.

As the evening progressed it became apparent the bill would fail despite the conviction of all senators in the majority and nine Republican senators: Coleman (Minn.), Collins (Maine), Dole (N.C.), Murkowski (Alaska), Roberts (Kansas), Smith (Ore.), Snowe (Maine), Stevens (Alaska), and Voinovich (Ohio). This bill's failure to pass in the Senate due to procedural rules, despite a majority vote, 58-40, now results in Medicare reimbursement rates to physicians and their staffs being cut by 10.6 percent.

How will this affect the seniors of South Carolina?

They will most likely feel no immediate effect. Physicians across the state will walk into their offices, turn on the lights, greet their staff, and start seeing patients as usual.

No Medicare patients with scheduled appointments will be turned away, no scheduled operations or procedures will be cancelled; in general, there will be no immediate disruption to patient care.

While Congress and the White House insist on playing what looks like a political game of 'chicken,' with patients and their physicians caught in the middle, the health care system will march on.

But our commitment to serving our patients does not make up for the fact that already-struggling practices, most of which are small businesses that face the same challenges that other small businesses face, will be hurt by this payment cut.

Some, especially primary care practices, may not survive.

I encourage everyone to contact the members of our congressional delegation and urge them to find a way to work with their colleagues to reverse this destructive reduction in Medicare payment.

Dr. Dawn E. Clancy is governor of the South Carolina Chapter, American College of Physicians.