Congress plans cuts in Medicare payments to physicians every year, and usually doesn't follow through. But a 10 percent reduction is slated for 2008 - and a 40 percent cut is on the books through 2016, meaning Utah doctors stand to lose $30 million next year and a total of $1.2 billion over the next decade.

It's already difficult for seniors to find doctors willing to accept Medicare patients, and a recent survey of physicians shows it will become even harder if the cuts are made.

"A very significant number of physicians in this country are facing the fact if reimbursements don't improve, they've got to make severe changes in their practices," William Plested III, president of the American Medical Association, said while visiting The Salt Lake Tribune editorial board Tuesday. "This is a real, looming problem."

He was in Utah - and has been traveling the country - to bring attention to the cuts, hoping residents will lobby their congressional delegation to not only avert the reductions but boost physicians' payment rates by around 2.5 percent a year.

The AMA survey, released last week, showed that most doctors - up to 77 percent - would limit the number of new or existing Medicare patients they would accept if the cuts are made.

That's because Medicare payments haven't been covering the cost of care, according to AMA figures.

Costs are projected to increase 20 percent by 2016, even as the 40 percent cuts are planned.

The disparity in cost and reimbursement is already leading doctors to refuse to care for Medicare patients.

Catherine Wheeler, an ob-gyn and past-president of the Utah Medical Association, said her office has stopped seeing Medicare patients. She continues to care for her existing patients, but doesn't charge them or Medicare. "I don't feel right billing them," she said.

Patients who can't find a doctor end up in the emergency room in worse condition, said Mark Bair, the UMA president-elect and an emergency-room doctor from Payson.

"We're already seeing in the emergency room, patients who walk in with letters from their doctor and say they have been discharged from the practice or they can no longer go to this practice because they're no longer accepting Medicare," Bair said.

The lack of access is only expected to get worse. National figures show 25 percent of newly eligible Medicare patients have a tough time finding a doctor - and that's before the first wave of baby boomers reach age 65 and become eligible for the subsidized care.

In addition, Utah doctors will be retiring, too. Almost 40 percent are over 50 years old.

The cuts would not only affect Utah's 216,000 Medicare patients, but also almost 63,000 members of the military, whose benefits are tied to Medicare.

Sen. Bob Bennett, R-Utah, who has been working on health care reform, said he supports efforts in Congress to delay the cuts, but noted it is a short-term fix.

"We must find a permanent solution to ensure better health care for seniors," he said in a statement.

hmay@sltrib.com