Capitol Hill Rally Pressures Congress for Medicare Payment Reform

The AMA made a congressional "house call" on April 2, staging an outdoor rally on Capitol Hill at which more than 250 physicians gathered to demand Medicare payment reform.

"We know the current Medicare system is unfair," said FP Gerald Harmon, M.D., of Georgetown, S.C., one of two family physicians to address the rally. "It is a storm, a disaster waiting to happen -- a disaster that is going to affect millions of our elderly. It is going to break the hearts of dedicated physicians around the country."

The AMA held the rally on the last day of its two-day national advocacy conference, which brought physicians to Washington to lobby against an impending 10.6 percent cut in the Medicare physician payment rate scheduled to take effect July 1. During the 30-minute rally, white-coated physicians carried purple and white placards that said, "Stop Medicare Physician Cuts" and "Help Doctors Help Patients," as they chanted, "We care, be fair," in a demonstration of solidarity before meeting with their representatives and senators in House and Senate offices.

The threat of an impending Medicare physician payment cut, coupled with low Medicare payment rates, has created an unstable and untenable business environment for many physician practices, forcing some practices to close and others to reduce their Medicare patient base.

"Some of you, regrettably, have had to close your practices," Harmon told the physicians at the rally. "When that happens, thousands of patients are looking for another medical home."

Harmon said his rural area of South Carolina has lost 25 percent of its primary care physicians in the past year, as well as a number of subspecialists, leaving thousands of Medicare patients searching for physicians.

"We have tried to hang on to these patients, hang on to medicine for them," said Harmon. "We have eliminated raises for our staffs. … We have taken pay cuts. We have forestalled any kind of retirement planning. We have reduced staff, and on rare occasions, we have had to cut staff."

FP Mary Carpenter, M.D., of Winner, S.D., tried to put the Medicare payment issue into broad historical context by quoting some of the U.S. presidents whose faces are carved into Mount Rushmore in South Dakota.

"Thomas Jefferson certainly believed in taking the fight to the powers that be," Carpenter said. "He wrote, 'Do you want to know who you are? Don't ask -- act. Action will delineate and define you.'"

"(Roosevelt) would likely tell us that now is our time to rally for our cause," Carpenter added. "Patients across this nation want the access they deserve."

Nancy Nielsen, M.D., Ph.D., an internist from Buffalo, N.Y., and president-elect of the AMA, also urged Congress to "act now," telling federal lawmakers, "We care for seniors, now you be fair to us."

Nielsen called on Congress to pass the Save Medicare Act of 2008, S. 2785, (at the THOMAS Web site, type "S. 2785" in the search box after selecting "Bill Number") a bill introduced by Sen. Debbie Stabenow, D-Mich., that would block both the 10.6 percent physician payment cut scheduled for July 1, and a scheduled 5 percent reduction in 2009.

"This (bill) gives Congress 18 months to work to find a solution to the ridiculous Medicare physician payment problem," Nielsen said.

Congress has fewer than 90 working days left before the Medicare payment reductions take effect, giving federal lawmakers "no time to waste," Nielsen said.

"We already know one-third of seniors are having a problem finding a primary care physician," she said. "We know that 60 percent of physicians have said if these cuts that are coming July 1 go into effect, they will not accept any new Medicare patients."

"This is not just a national problem," she added. "This is a problem in everyone's hometown."

The AAFP has taken a lead role in opposing the Medicare cuts and rallying support for the Save Medicare Act of 2008. In early February, the Academy launched the Medicare: Stop the Cut Campaign, which has bolstered the voice of family medicine on Capitol Hill while strengthening the bonds between family physicians and their patients, who are jointly warning Congress about the effects of the pending Medicare cuts. The campaign has generated more than 1,900 member e-mails to Congress denouncing the pending payment reductions and urging Medicare payment reforms.