Murray Tucker: Primary care concern
September 15, 2008
To the editor:
This summer, Congress passed, over a Presidential veto, the Medicare Improvements for Patients and Providers Act of 2008. If the override had not occurred, an automatic provision would have reduced primary care physician fees by 10.6 percent.
Senator Kennedy traveled to D.C., from his hospital bed in Massachusetts, to cast his vote to override the veto.
Most Republicans voted to sustain the veto. John McCain was present but not voting, giving tacit support for the President’s veto.
We need incentives to attract primary care physicians, not deterrents.
Primary care physicians are the front line for diagnosis and referral.
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In the very near future, having health insurance may no longer be our ticket to receiving optimum care. More and more people are referring themselves to specialists. Increasingly, medical school graduates are shunning primary care for the more lucrative specialties. A recent survey indicated that only 2 percent of these graduates are considering general, family, pediatric or internal medicine practice (TIME, 9/10/09).
In response to a questionnaire from the American Academy of Family Practice, Barack Obama acknowledged the need to change the reimbursement system.
Obama wrote: “Medicare’s reimbursement for doctors is based on a formula that is antiquated, ineffective and overdue for major revision. Any serious proposal to reform this nation’s health care system must prioritize fair and reasonable payment to doctors to ensure access to high quality care for seniors.”
Senator McCain did not respond to the survey. The insurance plan he supports will make employer contributions for health insurance taxable to workers.
His concept is to remove the current incentive for such insurance and make the decision one of individual choice. Faced with a premium of $12,500, a family of four earning $50,000 a year is likely to pass, increasing the ranks of the uninsured.
Murray Tucker, Ph.D.