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Letter - Medicare cuts stopped for now, crisis still looms

The voices of patients and their physicians were heard loud and clear last week, with Congress' overwhelming vote to override a presidential veto and stop impending Medicare payment cuts of almost 14 percent for physician services in North Dakota. Our physicians through the North Dakota Medical Association wish to express our appreciation to Rep. Earl Pomeroy, D-N.D., and Sens. Kent Conrad, D-N.D., and Byron Dorgan, D-N.D., for their ongoing support and tremendous efforts for preserving quality, affordable medical care in our state. This vote assures continued access to vital health care services for North Dakota's senior citizens.

Notwithstanding the vote, Medicare payments to North Dakota are far less than most other states due to geographic formulas used by the federal government to decrease payments to our state. In fact, newspaper reports over the past several months have highlighted the concerns of physicians and hospitals in our state over low, unfair payments by all payors for medical services in our state as compared to other states. And not only Medicare but also state Medicaid and commercial insurers such as Blue Cross Blue Shield of North Dakota. NDMA physicians are very concerned that this continuing trend of poor payment does not bode well for the future of health care in North Dakota, and in time the access and quality in health care enjoyed in the state will deteriorate rapidly as health care resources become increasingly scarce and health care workforce and capital needs are not met.

The reprieve received last week on Medicare is only a short-term fix for a complex issue. For several years, this payment formula has calculated reductions in payments in the face of continually rising operating costs in physician practices. The payment formula now projects over a 20 percent reduction in payments beginning Jan. 1, 2010. This would create a literal meltdown of the Medicare program as we know it.

Congress has created an 18-month window of time in which they can resolve the problems inherent in the current physician reimbursement formula. We hope to work with our Congressional Delegation to do just that. Eliminating the inequities of the formula is the only way to end the annual threat of drastic cuts shutting down access to Medicare services.

Dr. Robert A. Thompson

President, North Dakota Medical Association