Seniors See a Doctor Shortage

But for transplanted and local retirees alike, getting to see a doctor can be even harder than registering for one of Boulder's overbooked computer classes for seniors. Medicare cards, long considered a guarantee of health care in old age, are proving little better than fool's gold.

Because the Medicare program has reduced the amount it reimburses doctors, many seniors now have to make as many as a dozen phone calls just to find a physician who is still accepting new Medicare patients. Others were dropped by their longtime doctors when they turned 65. "Seniors are going without care, and patients are getting sicker," said Jim Peters, vice president of Boulder Community Hospital. "We are close to a crisis."

Colorado is merely one of the more dramatic examples of a trend that is sweeping the country and threatening to undermine Medicare. Many Medicare cardholders have supplemental insurance for prescription drugs and other uncovered expenses, but since its enactment in 1965, Medicare has provided basic health benefits for all senior and disabled Americans.

Until now, at least. The aging of the population -- combined with escalating health-care costs, cuts in Medicare reimbursements, problems with Medicare HMOs and political gridlock in Washington -- is producing a physician shortage so severe that social service agencies in some communities now count Medicare beneficiaries with the homeless and the uninsured as being "medically underserved."

The nonpartisan Center for Studying Health System Change recently found that about 1 in 9 Medicare beneficiaries reported delaying care or being unable to find a physician last year -- before this year's 5.4% cut in physicians' fees took effect.

And with the announcement expected soon of a 4.4% cut for next year in Medicare payments to doctors, the situation is likely to get even worse.

"If Congress does not reverse the cut, you will see a perfect storm," said Dr. Jeremy A. Lazarus, a psychiatrist and president of the Colorado Medical Society. "Physicians will stop seeing even current Medicare patients."

A bill to restore billions of dollars in reimbursements to doctors is pending in Congress, but action this year appears unlikely.