Doctors raise Medicare concern

Medicare beneficiaries are being abandoned by the "physicians who treat them and the politicians who represent them," one longtime Ashland physician says.

Dr. John Maurer, who has practiced orthopedics in Ashland for 33 years, said if you are new in town and are on Medicare then you'll likely have a difficult time finding a physician because the government pays doctors poorly to care for those 65 and older.

"I think it's a travesty that no one will tell the Medicare seniors exactly what the situation is," Maurer said, "and it's horrible that people are selling the new Medicare Advantage plans under the guise that it's going to grease your way into seeing a doctor. That is just not the case." &



Medicare has to be seen for what it is, Maurer said in a lengthy interview.

"If you're living off a Social Security check every two weeks then Medicare is perfect for you," he said, "but if you retired to Ashland on a 401(k) plan that gives you some latitude you'll recognize that Medicare just isn't going to happen for you."

Maurer, a former president of the Jackson County Medical Society and chief of staff at Ashland Community Hospital, said the problem is the result of the low reimbursement rate the federal government gives health care professionals for treating Medicare patients.

He said if wealthy seniors begin to opt out of Medicare the national crisis could turn catastrophic locally given the few number of physicians in Ashland.

"Ashland's population that lives above The Boulevard, I can guarantee you, when the Medicare line gets long enough they will be the first to exit the ship," Maurer said. "The limited number of providers in Ashland is going to be gobbled up by those who can pay and God help the rest."

Dr. Allen Douma of Ashland, a nationally known health economist and member of the AARP Oregon executive committee, said across the country Medicare rates are lower than private sector rates.

In Oregon, physicians are paid less than in most other parts of the country because of the complex formula that the U.S. Centers for Medicare and Medicaid Services uses to determine regional reimbursement rates for providers.

The rates were based originally on, among other things, cost of living and the prevailing rates being charged in the 1960s, when Medicare was established, and adjusted since for inflation.

"What's happened is all of the rates have been inflated, but if you start from a low base, you stay at a low base," Douma said, noting that some say Oregon providers could be paid about six percent less than doctors in other regions.

"As a result, there are many physicians now who are taking fewer or no more Medicare patients and others who have no Medicare patients and won't take any," Douma said. &

Doctors in Southern Oregon who have practices with more than a 70 percent concentration of Medicare patients cannot afford to keep their office lights burning, Maurer said.

He noted that in 1984 Medicare paid him about $2,500 to perform a total hip replacement.&

This year, the federal government pays him just $1,100, partly because of technological advances that allow surgeons to perform the procedure in less time.

Physicians nationally were headed for a 10 percent Medicare rate cut in Medicare Part B payments for outpatient services beginning Jan. 1.

Legislation pending in Congress would grant Maurer and other providers a six-month reprieve and they will get a 0.5 percent raise to treat Medicare patients.

U.S. Sen. Gordon Smith, R-Ore., a champion of the bipartisan proposal, is hopeful that Congress can "find a balanced solution that protects the future of the Medicare program as well as ensures access to doctors for seniors," his spokeswoman said.

covers government for the Ashland Daily Tidings.&

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