05/10/2010 05:12 am ET Updated May 25, 2011

21% Cut to Medicare Will Create Two-Tier Health Care System

If Congress allows the 21% cut in Medicare payments to physicians then many physicians will choose to stop seeing Medicare patients. The House Clinic has never turned away patients for lack of money. I hope that we won't have to begin now.

Most doctors will not want to do it but they're left with no other choice. It will simply become too costly for a physician to continue to see Medicare patients.

A physician's practice is essentially a small business. Every small business has bills to pay. There is payroll for the staff, rent, electricity, equipment and office supplies.

But, let's say a doctor continues to see Medicare patients. To make up for the lost income from the lower Medicare reimbursement, a physician will increase the rates for services for the insurance and cash paying customers. How is it fair to the insurance and cash paying patients to subsidize the Medicare system?

The other option for physicians will be to see more patients and spend less time with each patient. Patients already complain they spend more time in the waiting room than in the exam room with the doctor, can you imagine if doctors try to cut it even shorter?

A 21% cut would effectively create a two-tier health care system. People with health insurance or the ability to pay cash will be able to choose any doctor they want to see. But, Medicare patients will have a limited number of doctors available to them as more physicians stop seeing them.

Health care reform should not start with a 21% cut to Medicare payment rates to physicians.

The Sustainable Growth Rate (SGR) formula was created by Congress to control costs of Medicare. From the start, SGR never worked the way it was intended. It is unfair to cut the Medicare payment to physicians because the cost of all areas of medicine is increasing. This increase is a result of better technology, better drugs and longer life spans.

If something doesn't work year after year for this many people, then change it. The SGR needs to be eliminated. A reasonable reimbursement rate needs to be established with an annual cost of living increase.

We don't want to stop seeing Medicare patients but we will if Congress leaves us no other option.