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Survey Shows Medicare Restrictions Hurt Patients

WASHINGTON D.C. -- Senior citizens are having trouble finding doctors to treat them. The reason? Government red-tape and cost controls which have resulted in rationing.

That is the stark finding of a survey of doctors conducted by the Association of American Physicians and Surgeons released today at the "Congressional Briefing on Aging" sponsored by the Seniors Coalition. The survey shows that Medicare regulations thought to protect patients are actually responsible for severely restricting patients' access to medical care.

Take the case of 96-year old Elsie Rittman of Tucson. When told by a doctor he couldn't afford to take on any more Medicare patients, she offered to pay him herself. She was told it was illegal to spend her own money to see the doctor of her choice.

So Mrs. Rittman wrote HHS Secretary Donna Shalala, "I find it hard to believe I can't spend my money to see the doctor I want. Please write me a letter that tells him that it is legal for me to pay him for the services I want without using my Medicare."

The government's reply? In a word, no! "I cannot give you a letter saying that it is legal for your physician to accept payment directly from you," wrote Kathleen Buto, Director of Bureau of Policy Development for the Health Care Financing Administration of HHS. And further, Mrs. Rittman was warned that any agreement between her and the doctor would be evidence of violation of Medicare law, punishable by fines and/or sanctions.

Is Mrs. Rittman's an isolated experience? No, according to a nation-wide survey of physicians conducted by the Association of American Physicians and Surgeons released today.

Medicare-eligible patients throughout the country are finding it difficult to find a doctor who will treat them. Almost one-half of doctors surveyed restrict services to Medicare patients. The reasons: hassles or threats by Medicare and cuts in reimbursements.

"The survey comments indicate a growing sense of frustration and helplessness with the direction of the practice of medicine," said Dr. Jane Orient, AAPS Executive Director.


AAPS Medicare Survey......2

The mailed survey of 338 physicians conducted by AAPS details for the first time the impact of Medicare regulations on patients' access to medical care. Some findings:

> Almost one-half (46%) report restricting services to Medicare patients;

> Almost three-fourths (74%) of physicians who restrict services to Medicare patients do so because of hassles and/or threats from Medicare, and 75% do so because of cuts in reimbursements (respondents were allowed more than one choice);

> Medicare pays only 50% of the doctors' actual fees;

> More than one-third (37%) have trouble finding referral physicians for their Medicare patients;

> More than 70% plan to retire from patient care at a younger age than they would have considered five years ago.

"The solution is clear," said Dr. Orient. "We need to allow patients the freedom to contract directly with the doctor of their choice."

Sen. Jon Kyl of Arizona has a bill which would remedy the situation. The "Senior Citizens Health Care Freedom to Contract Act" guarantees patients' rights to privately contract with the doctor of their choice for the medical treatment of their choice.

"Without this bill, the predictable result will continue to be that seniors no longer have the right to choose treatments which they can afford to pay in full," said Sen. Kyl. "This result will ensue from the well-known fact that many physicians are unwilling to participate in Medicare since Medicare reimbursement frequently covers only 60 to 65% of the actual cost of care."

"It's clear we need changes in the system to preserve quality care for our patients," said Dr. Orient. "Congress has an historic opportunity to pass the "Senior Citizens Health Care Freedom to Contract Act."