Your access to health care depends on Congress

Our state faces a serious shortage of primary-care physicians. In fact, 55 counties in Georgia are now classified as primary care health shortage areas.

That's not good. Research has consistently shown that without the primary-care physicians who help you stay healthy, take care of you when you get sick and work with you to manage a chronic health problem, you have a greater chance of being hospitalized, developing potentially life-threatening problems and shortening your lifespan.

Why are so many counties going without enough primary-care physicians? The answer is complex, but a major contributor is the way we pay primary-care doctors for the services they provide.

Doctors' offices are vital to their communities, but they also are small businesses that must generate enough income to keep their doors open. For seven years - since 2000, when primary-care doctors saw an average 7 percent drop in their businesses' income - federal Medicare policy has been driving existing primary care doctors offices out of business and discouraging medical students from choosing a career in family medicine or general internal medicine.

For seven years, annual changes in Medicare reimbursement have either stagnated or dropped from the previous year. For seven years, Medicare reimbursement to physicians has failed to match inflation. In fact, the average practice revenue for primary care doctors plummeted 21 percent in 2005, according to a medical economics survey. And although primary care doctors saw a 2 percent Medicare reimbursement increase in 2006, annual inflation that year was 2.5 percent.

And even worse, most major insurers use Medicare's calculation to determine what they pay your doctor. No matter which way primary-care physicians turn, they cannot generate the business income they need to keep their doors open.

This year, Medicare will make the problem worse. Without congressional action this spring, federal health policy will require a 10.6 percent cut in Medicare's physician reimbursement rates on July 1, 2008 and an additional 5 percent on Jan. 1, 2009.

We've heard about this before. That's because, each year, Congress fails to change the Medicare formula. Instead, they choose temporary Band-Aids that postpone the inevitable.

That approach allows Congress the luxury of short-term planning. But it worsens the uncertainty for Medicare beneficiaries. Elderly and disabled patients do not have short-term health issues. They cope with an average of five chronic conditions that, if not properly treated and monitored, can cascade into life-threatening complications. Without a stable Medicare system on which doctors can predict revenues, these elderly and disabled people cannot be certain their physician will be open for business when they need medical care.

You can do something about it. Congress needs to hear from you. Contact Sens. Saxby Chambliss and Johnny Isakson and your local U.S. House member, and tell them to support legislation that provides adequate reimbursement for the care you, your family and friends receive from your doctor.

The writers are, respectively, a family physician in Ocilla, and president-elect of the Georgia Academy of Family Physicians; and a general internist in Thomson, and vice president of the Georgia Chapter of the American College of Physicians.

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