AAFP Statement: Debt Ceiling Proposal Contains Pitfalls to Patients’ Access to Care

Monday, August 01, 2011

Statement attributable to:
Roland Goertz, MD, MBA
President, American Academy of Family Physicians

“The debt ceiling/deficit reduction plan being considered by Congress offers a potentially false promise to patients. It guarantees benefits but, by ignoring Medicare physician payment issues, it potentially denies the actual medical care those benefits cover.

“The legislation calls for $900 billion in immediate spending cuts. In addition, it requires $1.5 trillion in reductions in the deficit over ten years, but leaves the allocation of this second round of cuts and revenues to a new Joint Select Committee on Deficit Reduction, which will put forth a plan by Nov. 23 for Congressional consideration by Dec. 23. Failure to pass the plan and garner a presidential signature will mandate that $1.2 trillion in across-the-board cuts will be withheld from all federal spending with the exception of Medicaid, Social Security and Medicare benefits.

“The American Academy of Family Physicians appreciates the proposal’s preservation of Medicaid funding and Medicare benefits, but it still poses a grave threat to Medicare patients’ ability to get appointments with their physicians. How? By not addressing the deeply flawed formula on which all Medicare payment is based — the sustainable growth rate formula that under current law requires a 30 percent Medicare cut for physician care on Jan. 1, 2012.

“Extracting billions in savings by reducing Medicare payments to providers will have serious implications for family physicians — whose practices operate on extremely tight margins — and their ability to remain open and provide care for patients.

“Data from a 2010 AAFP survey show that a 25 percent Medicare pay cut — five percent less than what is required on Jan. 1, 2012 — would drive 13 percent of family physicians out of business. The loss of these practices goes far beyond the serious access problems for patients, particularly in rural and underserved areas that already struggle to find needed medical care. Family physicians generate an average of $1.3 billion in economic activity in their states. The closing of these practices would result in significant loss of revenue and jobs in communities across the country.

“Moreover, according to the 2010 survey, more than seven in 10 family physicians would be forced to limit the number of Medicare patients they can accept and nearly 62 percent will be forced to stop accepting new Medicare patients.

“If our health care policy fails to ensure the financial viability of physician practices, preserving benefits does little good. In the end, many patients in need will go without care because there will be no one to see them.”

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Founded in 1947, the AAFP represents 129,000 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.

To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit
www.aafp.org/media. For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website, www.familydoctor.org(www.familydoctor.org).