On Jan. 1, 2008, the formula that Medicare uses to set fees paid to physicians was set to cut their allowable amounts by 10 percent. Because Congress was not able to find time to fix this formula, legislators passed a stopgap measure before going on their Christmas break that delayed the cuts for six months, and gave physicians a 0.5 percent increase for six months. They figured they would have six months to fix the problem.

That six months expired June 30. Before going on their Fourth of July break, members of Congress were unable to agree on how to fix this problem. They passed another stopgap measure to give themselves another 10 days. Unfortunately, they did not return to work until Monday, and this measure expires Thursday.

If they cannot agree in that three-day period, and they allow this stopgap to expire, Medicare payments to physicians will be cut by 10.6 percent.

Tricare is an insurance that covers dependents of military personnel, including spouses and children left behind when your neighbors get mobilized to active duty in our National Guard. Payments for Tricare are directly tied to Medicare, and would also be cut 10.6 percent.

Over the past 10 years, we have slowly seen our reimbursements for many of our procedures decrease by about 25 percent. The cost of doing business, as you can imagine, has not gone down accordingly.

What does this mean? Many physicians, including myself, will not be able to afford to accept new Medicare and Tricare patients, if these cuts take effect.

The political buzzword seems to be "universal coverage," and the panacea often espoused on the Star Tribune editorial pages has been a single-payer system, i.e. Medicare, because it has low overhead, low administrative costs, etc. It also has low reimbursement for the physicians and facilities providing the care.

A recent commentary in the Star Tribune (Dr. Alan Goldbloom's "Get ready for higher medical costs,'' June 30) noted how Medical Assistance (MA) will reimburse hospitals (and also physicians, by the way) for their actual cost minus 10 to 15 percent. Why treat patients when it costs us money each time they walk in the door? We can absorb these costs, up to a point.

Physicians beware. If we end up with a single-payer system, then the lowest fee schedule we will accept MA will become the highest fee schedule we can expect.

Robert Gjertson is a podiatrist from Fridley.