Bush's Medicare plan would limit doctor choice, consumer group says

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Bush's Medicare plan would limit doctor choice, consumer group says

By Paul Wenske
The Kansas City Star, May 16, 2003

Medicare recipients would have fewer choices of doctors under a proposal requiring senior citizens to join private insurance plans to get drug coverage, a study contends.

The study, conducted in 23 Iowa counties, was released Thursday by Public Citizen, a Washington, D.C., consumer group that opposes President Bush's plan to privatize Medicare drug coverage.

Medicare recipients currently don't have drug coverage under Medicare unless they buy an outside drug policy.

Ben Peck, a spokesman for Public Citizen, said during a telephone news conference that the report rebuts administration claims that enrollees who leave Medicare for a private managed care plan would be able to choose any doctor they want.

He said recipients "very likely would find that their doctor was not a participating provider, forcing them to pay more, perhaps significantly more, to contribute to see that doctor."

The study was timed to coincide with debate this week on privatization proposals in the Senate Finance Committee, whose chairman is Republican Sen. Charles Grassley of Iowa.

The Iowa study was conducted in May. It compared the number of doctors in 23 counties who participate in Medicare with those who participate in seven preferred provider organizations that contract with the Federal Employees Health Benefits Program.

PPOs are similar to health maintenance organizations but allow members more options in choosing a doctor. Bush has cited the federal employees health plan as a model for reforming Medicare.

Mark Schlesinger, associate professor of public health at the Yale School of Medicine, said at the news conference that Medicare has been "strikingly better" at providing doctor choice for the elderly than private health plans.

He said private plans reduce costs by seeking doctors who agree to drop their costs, which can result in fewer doctors joining. He said private plans also have higher doctor turnover.

Robert Reuter, an Iowa senior advocate, said doctor choice is important to seniors.

"When a patient is confident with a doctor, it can have a profound impact on the quality of care," he said.

Peck also noted that private HMO plans around the country have dropped their Medicare members as their profits fell. Thousands of Kansas City area HMO Medicare patients lost coverage last year.

The president's proposal would offer several options to seniors. One is a discount card allowing low-income beneficiaries $600 per year to offset drug costs. Another option would allow seniors to join private plans that offer drug benefits.

The plan has received support from conservative lawmakers. But skepticism for the plan has been expressed by both parties.

Grassley has said he favors a universal drug benefit "so seniors who want to stay in traditional Medicare get a prescription drug plan that's just as good as those who choose a new option."