By William Klepack
Guest Column
The Ithaca Journal
July 31, 2008
In early July, Congress passed a bill to prevent a scheduled cut in Medicare payments to doctors. Although I am pleased with the outcome of this vote, there are several reasons that senior citizens should be concerned about the political maneuvering affecting their care that surrounded this bill and be very interested in single-payer health care.
First, Senators voting against the bill were protecting insurance industry profits at the expense of seniors. The bill reduced insurance company profits by an amount necessary to balance the Medicare budget. Senators voting against this bill were, effectively, manipulating seniors’ health care to benefit the insurance companies’ bottom line.
Second, seniors should be upset because this was just the most recent threat in a long pattern of erosion of payments to their personal physicians, and this trend is starting to have an impact on seniors’ access to care. Primary care doctors (family physicians and internists) have worked tirelessly on behalf of Medicare patients, even as Medicare compensation for their services has stagnated since 2001. Physicians have experienced large increases in overhead costs during that period, and primary care doctors simply cannot continue to sustain their businesses when costs rise and payments do not keep pace with both those costs and inflation.
The result of this ongoing trend is that seniors are having more difficulty finding a physician. In March, the Medical Group Management Association reported that nearly 24 percent of all physicians had begun limiting or not accepting new Medicare patients. In December, the Medicare Payment Advisory Commission reported that, nationally, three out of 10 Medicare patients had trouble finding a primary care physician.
Since having access to health care is the single most important factor influencing health, these adverse trends point out serious problems with our current system.
Seniors should support single-payer health care because, under such a system, patients’ access to health care would not be subject to manipulation for insurance company profits. Private insurance companies would not be raking in exorbitant profits — profits that deliver no health care.
Another reason seniors should support single-payer health care is because a health-ministry-type system would no longer be the political football that the current system has been in recent years. If a nonpolitical health ministry were making health care funding decisions, then the power of the insurance industry to influence legislation ensuring their profits would cease.
Seniors should also support single-payer health care because it would establish payment levels that enable their doctors to keep their doors open and simultaneously make the health care dollar deliver more health care. A national board charged with negotiating with physicians would come to an agreement on rates.
The current Medicare insurance card has no value unless there is a doctor in the house. We not only need a doctor in the house; we need every dollar to go farther in delivering care.
Dr. William Klepack is a family physician practicing in Dryden and is medical director of the Tompkins County Health Department. The opinions expressed above are his personal ones and do not reflect Health Department or Tompkins County policy.
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