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After several years working in the medical billing/coding world, my experience is that Medicare's low reimbursement ultimately hurts patients by limiting the number of doctors willing to accept them as patients. Regardless of how we all feel about the relative prices for doctor services, the bottom line is that costs must be met in order for the doctor's office to remain open. If the reimbursement doctors receive from Medicare does not allow them to cover these costs, the result is that the provider will seek to limit the number of Medicare patients in their practice, or simply stop seeing Medicare patients all together. These patients, who often require frequent medical attention, will be forced to find another doctor.

Those doctors that do continue to see Medicare patients will be forced to see a larger number of patients in a day to continue to meet their overhead costs. As anyone knows who has been rushed through a 15 minute exam with a doctor after waiting an hour in the waiting room, it is almost impossible to address all a patient's concerns in this limited time frame, and still complete the required basic physical exam required by Medicare for reimbursement of the visit. By not allowing the provider to spend the time he/she needs to address all areas of patient concern, warning signs of potential illness may be missed, requiring more extensive, and more expensive, treatment in the future.

As this trend continues, patients have to travel farther to find a doctor willing to accept Medicare as payment for services, and so often delay visits to the doctor until an emergency arises. As preventative care is generally more cost effective than emergency treatment (which can result in hospital admission), the end result is that the patients are sicker, and we, as taxpayers, are paying more for their care.

Rather than simply cut down the reimbursement for all services, Medicare should instead create incentives for providers and patients to encourage the utilization of preventative services. Increasing the rate of reimbursement for annual check-ups and associated routine lab tests would allow doctors to continue to see these patients without having to cut appointment times. And, as Medicare fees set the trend for payment schedules in the private insurance field, increased reimbursement across the board would help encourage a culture of preventative medicine, rather than reactive, emergency medicine, allowing us as a whole to live healthier, longer lives.

Learn more about this author, Liz Westlake.
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