Houston – Millions of Texans are taking Medicare, but the future will be in Limbo as the US Senate plans to vote for the new leader.
Dr. Bruce Scott, president of the American Medical Association, sat at KPRC 2 while visiting Houston, expressing serious concerns about the current state of Medicare.
“There's this complicated formula where Medicare pays for doctors, and the formula is broken and has led to continued cuts and cuts in the near future despite Medicare itself saying costs are rising,” Dr. Scott said. “For example, there has been a roughly 3% reduction since January 1, 2025, but they say they think our costs will rise by 3.5%. That's unsustainable.”
Dr. Scott also said that Medicare physician reimbursement rates have plummeted nearly 30% since 2001.
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Because premiums are also in line with Medicare, that's not just a problem for physicians who accept Medicare.
“All insurance companies I have contracted with have their payment rates tied to Medicare fees,” he explained. “But why don't they? They know it's been a downward spiral for the past 20 years, so they tie their rates to Medicare rates. So, that's what it's like as a private practice doctor. I'm basically not paid much by all payers for what I did today for what I did 20 years ago.”
Currently, the American Medical Association is concerned that this is hurting patients. Dr. Scott gave an example of when a patient felt unhappy with the system and abandoned the doctor's recommended treatment.
“I think the first solution is to get a Medicare payment formula that actually pays the physician's practices related to the cost of providing care,” he proposed. “The second thing we need to do is to reduce some of the administrative burden… I've completed a pre-authorized permit form that doctors spent an average of 13 hours a week. If we can take away half of that and give all our primary care doctors six hours a week, that's another six hours to meet patients.”
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Dr. Scott encourages annoyed patients to write letters to lawmakers. He said patients have more power than they think.
“I think outroar is necessary to say that patients in the US are “needed to have access to doctors.” ” he concluded. “Some of this is ridiculous.”
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