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| Protecting Medicare in New Mexico |
February 19, 2002 |
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Dear Friends,
On Valentine`s Day, when the Chairman of the Health Subcommittee pounded the gavel and started the Medicare hearing, I was ready. Tom Scully, head of the federal agency that administers Medicare was the first witness and I had some things to say.
The hearing was on fixing the physician payment formula for Medicare. The Medicare formula for doctors has everyone`s attention at the moment because the slowdown in the economy will result in a decline of about 5% in physician payments from Medicare across the country.
Health care and the exodus of doctors from New Mexico is a real problem. Medicare formulas are one of the big reasons why.
The formulas for federal Medicare payments would make a calculus student wince, but there is a factor in it for "geography" that really means the federal government calculates average wages county by county across the country. They pay less for health care in New Mexico. A lot less.
There are about 7,000 different procedures, each with its own payment in different counties, for doctors. But when you add them all together, this is what you get: in fiscal year 2000, the federal government paid $3,726 per enrollee for Medicare in New Mexico. They paid $6,539 per enrollee in Texas, $5,100 in Colorado, and $4,464 in Arizona. Only 5 states or territories were reimbursed less per enrollee than New Mexico -- Puerto Rico, Vermont, Virgin Islands, Iowa and Maine. The feds pay 75% more in Texas? No wonder doctors are going over the border to practice medicine.
"New Mexicans don`t pay into Medicare based on where we live," I told Scully. "And we should not be denied access to quality health care because of where we live."
Thousands of New Mexicans rely on Medicare for their healthcare, and most private insurance companies tie their reimbursement rates to what Medicare will pay. These reimbursement schedules that pay doctors more for the same service in other states is the number one reason why we are losing doctors in New Mexico.
We need to change this system.
We fought the fight on Medicare Choice 18 months ago and saved access to health care plans for 15,000 New Mexicans. Now we`re going to tackle the next problem: eliminating or reducing more of the geographic disparities in Medicare.
It will be an uphill climb. The states on the top of the heap that are benefiting from this payment system have lots more votes than we do. But we have to shine some sunlight on this inequity and fight the good fight. I look forward to it.
Wish you were here,
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