Wednesday, January 30, 2002 - Page updated at 12:00 AM

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Many doctors opting out of Medicare

Seattle Times staff reporter

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The doctors delivered their diagnosis yesterday: Washington's health-care system is in serious decline, and the prognosis is guarded.

Tests show the severity of the problem, said Tom Curry, executive director of the Washington State Medical Association, which released a gloomy report in Olympia.

Responding to an informal poll of members in November, 57 percent of physicians said they are limiting the number or dropping all Medicare patients from their practices, the report says.

In a different poll last month, 30 percent of physicians said they had begun limiting Medicaid Healthy Options and Basic Health Plan patients they will treat. An additional 28 percent said they'd decided to drop all Healthy Options patients — up from 10 percent from a poll a year earlier — and 24 percent said they would drop all patients covered by the Basic Health Plan, the state's program for low-income residents.

Curry blamed the doctors' decisions on low federal and state reimbursements.

The report was compiled by an arm of the medical association.

The report, which represents the views of doctors, is not just about doctors' well-being, the association argued: It's about the ability of patients in the state to get care and about the state's economic health as well.

The report says that for many years the state's health-care delivery system has been in decline, characterized by a slow erosion of funding for public health, growing administrative expenses for practitioners and mounting frustrations of physicians trying to cope with myriad regulations.

A growing number of patients, even those with private insurance, are having trouble finding a physician because increasing numbers of doctors have been leaving the state or retiring early since the late 1990s, the report says.

And as the capacity of medical groups to absorb more patients shrinks, hospital emergency rooms are becoming increasingly crowded, the report says.

As for low reimbursements in subsidized health plans, the report compared Medicaid payments with some other common expenses.

For example, for an office visit, a doctor is reimbursed by Medicaid just $13.40, the report says. By contrast, the cost of a take-out pizza is $19. For a skin biopsy, the doctor is reimbursed $26.89, while a person would pay $40 to go to a tanning salon.

There will be no "magic pill" for the state's health-care ills, said Curry.

But the association is actively promoting some small-scale reforms, both state and federal, that could make a difference, he said.

Curry said the association also supports changing the federal tax code to allow individuals, as well as employers, to reap tax breaks for buying health insurance.


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