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ACP-ASIM Warns of Declining Patient Access to Health Care

Congress Urged to Take Quick Action

January 21, 2003

(Washington, DC): Congress needs to take quick action to fix policies that reduce patient access to physician services nationwide, said Sara Walker today, president, American College of Physicians - American Society of Internal Medicine.

The ACP-ASIM has released a grim picture of the current health care system in a report entitled "The Growing Crisis in Access to Medical Care: Causes and Remedies." Calling the document a report on the state of the nation's health care, the physician's group identified key factors reducing patient access to care.

  • Between 2000 and 2001, the number of Americans without health insurance rose by 1.4 million to over 41 million persons, nearly 15 percent of the population.
  • Over one million low-income Americans will soon be dropped from Medicaid.
  • Fewer uninsured patients had a regular source of care or saw a physician in 2001. The percentage of uninsured persons with a usual source of care-which is already far lower than for any insured group-dropped to 64.2 percent in 2001, down from 68.6 percent in 1997, and the proportion of uninsured persons seeing a physician dropped to 46.6 percent in 2001, from 51.5 percent in 1997.
  • Small employers are passing on higher costs to their employees and cutting back on benefits and eligibility.
  • Fewer physicians are willing to see new Medicare patients, at least in part due to Medicare payment cuts. The percentage of physicians saying they accept all new Medicare fee-for-service patients declined by 7.2 percent from 1999 to 2002.
  • Rising medical liability insurance premiums are forcing many doctors to limit services, relocate their practices, or retire early.
  • Physician concerns about the billing paperwork and administration required by Medicare are leading many to limit acceptance of Medicare patients. A recent survey of physicians found almost 75 percent were concerned about this "hassle factor" and 16 percent said that they had limited their acceptance of Medicare patients because of this factor.

The Congress and the President must commit to a multi-faceted budgetary and legislative strategy aimed at ending the crisis in health care access, particularly the crisis in access to physician services, according to the report. Key congressional steps include halting declining Medicare payments, reducing excessive hassles and red tape in the Medicare program, putting a cap on out-of-control liability premiums, expanding affordable health care coverage and assisting with the fiscal crisis that is threatening state governments' capacity to provide coverage for the working poor.

The College made a number of recommendations on how to improve the health care system and protect patient access to care.

  • The federal government should institute a temporary increase in the Federal Medical Assistance Percentage (FMAP), the matching rate that determines how much the federal government contributes to Medicaid.
  • Congress should commit to the goal of providing affordable coverage to all Americans by the end of the decade and begin phasing in sequential reforms to expand health insurance coverage consistent with that goal.
  • Congress should modernize Medicare's benefits by providing coverage for prescription drugs, evidence-based preventive and screening services, and geriatric assessments.
  • Congress should immediately enact legislation to halt another 4.4 percent cut in Medicare payments that will further reduce Medicare patients' access to physician services. A long-term solution should be found to restore physicians' confidence in Medicare by guaranteeing adequate and predictable payments that will keep pace with increases in the costs of providing services.
  • Congress should provide relief from budget cuts that threaten the ability of teaching hospitals to provide care to indigent patients.
  • Congress should enact legislation to ease Medicare hassles that are driving physicians away from the program.
  • Congress should enact legal reforms to slow the runaway costs of medical liability premiums, including a $250,000 cap on non-economic damages.

"The costs of implementing many of these recommendations will be substantial," said Dr. Walker. "But the costs of not doing so will be greater-measured not only in lost economic productivity, but in the suffering and even premature deaths of millions of Americans who were denied access to essential medical care."

The American College of Physicians-American Society of Internal Medicine is the nation's largest medical specialty organization and second largest physician group. Its membership includes more than 115,000 internal medicine physicians and medical students. Internists are specialists in the prevention, detection and treatment of illnesses that primarily affect adults. They provide care to more Medicare patients than other physician specialty.

(Editors: A full copy of "The Growing Crisis in Access to Medical Care: Causes and Remedies" is available online.)


Jack Pope
Phone: (202) 261-4556
E-mail: jackp@acponline.org

Page updated: 11-03-03

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