Doctors more reluctant to treat Medicare-funded patients

Doctors across the country [are] complaining that they've been forced to shift away from Medicare toward higher-paying, privately insured or self-paying patients in response to years of penny-pinching by Congress.

And that's not even taking into account a long-postponed rate-setting method that is on track to slash Medicare's payment rates to doctors by 23 percent Dec. 1... physicians have already been running print ads, passing out fliers to patients and flooding Capitol Hill with phone calls to convince Congress to suspend the 25 percent rate cut that the SGR method will require next year...

...government analysts and independent experts suggest that although doctors could not absorb a 25 percent fee cut, the claim that they have been inadequately compensated by Medicare until now is wildly exaggerated...

...statistics also suggest many doctors have more than made up for the erosion in the value of their Medicare fees by dramatically increasing the volume of services they provide - performing not just a greater number of tests and procedures, but also more complex versions that allow them to charge Medicare more money.

From 2000 to 2008, the volume of services per Medicare patient rose 42 percent. Some of this was because of the increasing availability of sophisticated treatments that undoubtedly save lives. Some was because of doctors practicing "defensive medicine" - ordering every conceivable test to shield themselves from malpractice lawsuits down the line...

"The argument that doctors literally can't afford to feed their kids [if they take Medicare's rates] is absurd," said Berenson. "It's just that doctors have gotten used to a certain income and lifestyle."

Regardless of their motivation, if doctors skew their patient base away from Medicare too drastically seniors' access to medical care could be limited.

Is that happening? Again, opinions vary...

Read the rest of the discussion at the Washington Post.