I like Ted Kennedy’s slogan “Medicare for all.” It reminds voters that America already has a highly successful, popular single-payer program, albeit only for the elderly. — Paul Krugman, June 13 2005
How “highly successful” is Medicare? Consider the following story from ABC News:
The Houston Chronicle reported last week that more and more Texas doctors are opting out of Medicare due to growing cuts in reimbursement. And the trend is not limited to Texas doctors. Primary care doctors from around the country have told ABC News that they too are either opting out of treating Medicare patients, or are preparing to do so if Congress once again OKs slashing reimbursement rates. …
“With the cost of running a medical practice only going up on a daily basis, and reimbursement taking a dive, how can doctors running a solo practice keep accepting a payer that only continues to cut its reimbursement?” said Dr. Gil Holland, a family physician in Chandler, Ariz. “This is problem is far reaching because as Medicare cuts its fee schedule, other insurance payers tend soon to follow suit. Many of my colleagues in Arizona are dropping Medicare.” …
According to the American Medical Association (AMA), reimbursements that have been reduced every year for nearly a decade have slashed physician payment rates by about 40 percent. Meanwhile, the cost of practice rises annually. The AMA estimates that this year practice costs will increase by 20 percent.
And according to a 2007 AMA survey of 8,955 physicians in the United States, 60 percent of doctors said they plan to limit the number of new Medicare patients and 40 percent of doctors said they plan to limit the number of established Medicare patients that they treat if Medicare payment rates are cut by 10 percent in 2008.
And because the Senate failed to block the latest reduction, this year’s Medicare cut of 10.6 percent has already taken effect — and an overwhelming majority of physicians contacted by ABC News say this will force them to either give up on Medicare patients altogether or limit the number of new Medicare patients they can treat. …
“I anticipate that Medicare patients will see a work slowdown — delayed access to routine and planned care or consultation — access problems with fewer providers, and downright strikes among physicians, especially sub-specialists,” said Dr. Michael Pontious, program director of Oklahoma University’s Enid Family Medicine Residency in Enid, Okla.
See also this excellent critique of Krugman’s Medicare endorsement.