By this time tomorrow, some 2,400 Americans will be dead from cardiovascular disease, which takes more lives each year than cancer, accidents and diabetes combined. By this time next year, though, rates of cardiovascular deaths may well have increased significantly if proposed Medicare regulations are implemented.
These changes are separate from the large health reform debate and have been crafted unilaterally by the Center for Medicare Services, the federal agency that administers the Medicare program. At issue is the amount Medicare reimburses cardiologists for life-saving diagnostic testing.
Medicare currently reimburses for some treatments at rates less than they actually cost to provide. But in January, these reimbursement rates could be cut in some cases by an additional 40 percent for imaging and other vital diagnostic tools cardiologists use daily to save lives.
South Carolinians' access to specialists and to timely diagnostic testing will be severely impeded under the new scheme, which will especially affect patients with heart disease. These reductions also will cause the closure of many offices and outpatient clinics, particularly in rural South Carolina where more than 182,000 of the state's half million Medicare policy-holders - a third - reside.
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South Carolinians will be proportionally harder hit than other Americans because of our higher percentage of senior citizens in rural areas.
Apparently, federal officials figure that by making it harder to access appropriate care, elderly patients simply will choose not to have that care. This kind of thinking amounts to rationing. In the long run, we will pay a price for this short-sighted thinking as mortality rates go back up and sicker patients enter the system at a later time.
These changes threaten to undo the excellent advances within cardiology that have been afforded our patients over the past decade, a period when mortality from heart disease has dropped 27 percent.
It's astonishingly ill-considered that the Center for Medicare Services proposed these extraordinary cuts in cardiovascular services when heart disease remains the biggest killer in this country. This isn't worst-case scenario bluster; it already is happening.
Take our practice, for instance. The S.C. Heart Center already has shut down our Chester office because of cuts. If these proposed changes are implemented, we will be forced to limit, or even close, other outlying offices, perhaps in Bamberg and Hartsville.
The consequences of closing rural offices would be significant. Instead of receiving needed testing at local offices, some would have to travel to hospitals or urban offices 50 to 60 miles away.
Test results that now are discussed with the patient within minutes would require several days' wait and likely another trip to the office. Such delays can be critical when dealing with heart-related problems, and without question this would increase the out-of-pocket expenses significantly for our rural patients already hard pressed by the difficult economic times.
Here's the cruel irony: The government says it wants to save us from a health care crisis, but these proposed changes actually are creating one in cardiac care. Denying access and timely care to our patients is not the answer to our Medicare problem.
The better solution is to allow access, but tie reimbursement to quality of care and to appropriate use of tests and procedures.
We have come so far in our battle against America's No. 1 killer. We cannot afford to turn back the clock. I urge Medicare and Congress to make a difference in protecting the heart health for all Americans.