Not only Medicare beneficiaries but also privately insured older Americans are reporting longer waits for physician appointments and delayed or unreceived care, according to the Center for Studying Health System Change, Washington, a nonpartisan policy research organization.
According to an analysis of the center's national household and physician surveys, 11% of Medicare beneficiaries reported delays in receiving necessary care or not getting care at all in 2001, compared with 9.1% in 1997. Meanwhile, privately insured Americans ages 50 to 64 who reported access problems increased to 18.4% in 2001 from 15.2% in 1997.
Both groups are waiting longer for physician appointments, the center reported. More than 40% of Medicare beneficiaries said they had to wait a week or longer to see a doctor for a specific illness in 2001, compared with 34.6% in 1997. And among privately insured older Americans, 36.3% reported more than a weeklong wait to see a clinician for a specific illness in 2001, compared with 29.9% in 1997.
Access to surgical and medical specialists was particularly a problem in 2001, with about half of each group reporting more than a three-week wait for a checkup with a specialist and almost 75% waiting more than a week to see a specialist for a specific illness.
"Americans of all ages are having more trouble seeing a doctor," center President Paul Ginsburg said in a written statement. "Reduced access to physician services is not just a Medicare problem; it's a systemwide problem."
The question for Congress, Ginsburg said, is "What's the tipping point for compromising physicians' willingness to care for Medicare patients?"
According to the center's surveys, the proportion of physicians accepting all new Medicare patients declined to 71.1% in 2001 from 74.6% in 1997, and the proportion accepting all new privately insured patients of any age declined to 68.2% from 70.8%.
The extent and type of access problems varied geographically, possibly reflecting "non-Medicare" factors such as demand, variations in private insurance, the number and type of available physicians, and market conditions, researchers said.
For example, only 55% of Seattle physicians would accept all new Medicare patients in 2001, compared with 71% in 1997. Nevertheless, Seattle ranked high on other measures of access to care, with only 8% of Medicare beneficiaries reporting delayed or not received care in 2001, compared with 15% or more in Cleveland, Indianapolis, Miami, Phoenix and Orange County, Calif.
Click here to read the center's report online.