With the passage of Medicare nearly 45 years ago, our nation made a promise to elderly Americans. We promised that they would no longer go without needed health care. For 45 years and, through their monthly premiums today, 44 million elderly Americans have paid for Medicare coverage. And yet we are breaking our promise to one in four of these patients:  today, 25 percent of elderly and disabled patients who are seeking a doctor cannot find one who is accepting Medicare patients.  

Why? Because instability in the Medicare physician payment system threatens the viability of thousands of physician practices and the health security of hundreds of thousands of their patients. Today’s physicians are compensating their nurses, physician assistants and other staff with 2010 wages. They are paying for electricity, heating and water at 2010 rates. They are buying medical supplies and equipment at 2010 prices. But under current Medicare payment system, their practices are earning 2001 income. At some point, they cannot continue the losses.  

That point may come one week from today. Unless Congress acts to stop the 21 percent Medicare pay cut to physicians, even more elderly and disabled Americans will find themselves holding a Medicare card that has little or no value.

This pay cut will – at best – reduce the quality of service. Some physicians will try to make up the difference by seeing more patients – shortening the length of time they can spend with each individual patient. Others will be forced to lay off nurses, physician assistants and other staff so vital to high quality care, convenient access and coordinated services. Others will have no choice but to restrict the number of Medicare beneficiaries they can accept. In fact, we’re already beginning to see this happen. In December, the esteemed Mayo Clinic in Glendale, Arizona, stopped accepting Medicare for its 3,000 primary care patients. Seven days ago, we learned that physicians in Texas are opting out of Medicare participation in droves.

And in the worst case scenario, physicians will close their practices — driven out of business or into retirement by a payment system that has frozen their practice income for nearly a decade while inflation has grown by 20 percent and that has continually threatened to slash the already inadequate payment for services rendered.  

This crisis is developing at a time when nearly one in four patients in family physicians’ offices is a Medicare beneficiary. In rural and underserved areas, one in three is a Medicare patient. In some practices, 60 to 80 percent of physicians’ patients depend on Medicare. This number will grow as more members of the Baby Boom generation become eligible for Medicare. The implications are clear. Access to needed medical care will plummet without a permanent solution to the Medicare physician payment system. 

This is not about money. It’s not about special interests. It’s about people. A generation of people who worked hard, paid their taxes, defended their country, educated their children, and built this nation. It’s about people who heard a promise — that we would ensure stability in their access to the physicians who care for them and the services that maintain quality life to the end.  

Without immediate action to halt the 21 percent pay cut next week and without additional action to permanently fix this deeply flawed system, Congress will renege on its promise of ensuring access to health care for their elderly and disabled constituents. We must pass HR 4213. We must keep doctors’ doors open. We must enact permanent Medicare payment reform because we must keep our promise of health care for our most vulnerable citizens.