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Medicare Must Preserve Patient Access to the Physician of their Choice

We all know that Medicare is very important to seniors, and we know that seniors are worried about its future and financial security. Seniors have paid into the system for many years and they certainly deserve to get what they were promised – a Medicare benefit that allows them access to the physician of their choice, even if he or she is no longer accepting Medicare. Unfortunately, under current law, they cannot. Thus, as the nation’s largest government-sponsored healthcare program, Medicare is clearly in need of change.

The current sustainable growth rate (SGR) physician payment system is one example of how Medicare is failing to serve our nation’s seniors and physicians. Baby boomers are now entering the Medicare program, there is a shrinking pool of primary care and specialty physicians, and it is increasingly difficult for seniors and individuals with disabilities to find physicians who accept new Medicare patients as the gap between government-controlled payment rates and the cost of running a practice grows wider. Physicians also are reconsidering their participation in Medicare as they face an increasing number of regulations and penalties for failing to comply with electronic health record meaningful use, quality reporting and other documentation requirements; thus further exacerbating the number of physicians available to treat the elderly.

Neurosurgeons are convinced that the key to preserving our Medicare patients’ access to quality medical care is to overhaul the flawed Medicare payment system. An essential element of payment reform includes allowing patients and physicians to voluntarily enter into arrangements known as private contracts. Ultimately, private contracting is an important way to ensure that our patients can maintain control over their own medical decisions. While the government may have the right to determine what it will pay toward medical care, it does not have the right to determine the value of that medical care. This value determination should ultimately be made by the individual patient, and by allowing patients to contract with the physicians of their choice for any amount not covered by Medicare, patients will have the power to exercise this value judgment.

Fortunately, there is hope on the horizon as Senator Lisa Murkowski (R-AK) and Rep. Tom Price, MD (R-GA) have both introduced legislation – the Medicare Patient Empowerment Act – which will allow patients and physicians to enter into such private fee arrangements, without forcing Medicare beneficiaries to forego the benefits that they have earned. The AANS and CNS, along with over 60 other state and national medical organizations – including the AMA and Alliance of Specialty Medicine – these bills. As Congress moves forward to develop proposals to reform Medicare’s broken payment system, at its core, this legislation should preserve patient access to the physician of their choice. Visit “” to learn more.

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