Maryland Gov. Larry Hogan (R) has proposed a budget that will, among other things, lower reimbursement rates for doctors who participate in Medicaid [“Hogan sets up budget cuts,” Metro, Jan. 23].

Perhaps it seems convenient to decrease government spending by reducing fees paid to physicians as the public continues to believe that doctors are overpaid anyway. Reimbursements for Medicaid patients are far below payments for other patients, so the doctors who accept Medicaid reimbursements effectively operate at a loss after incurring the cost of maintaining a practice.

I have been a gastroenterologist in Prince George's County for more than 40 years, now solo but for most of that time with a partner. From Day One we believed that it was our obligation to care for anyone who needed help, and our practice accepted everyone. Caring for Medicaid patients adds a burden beyond low fees. Public transportation makes many patients late for appointments. Some patients arrive with children or grandchildren who need to be cared for while examinations are conducted. Many of the needed drugs are not available on Medicaid, so we juggle treatments or find samples.

Most of my colleagues feel no obligation to accept Medicaid. If fees continue to decrease, more will opt out of the program. The solution would be to require every licensed physician to accept these patients. Under the Affordable Care Act, there will be more Medicaid patients and fewer doctors to care for them. This will become a health-care crisis, not just a budget one.

Barry H. Epstein, College Park

The writer is a former chairman of the Department of Medicine and former president of the medical staff at Prince George’s Hospital Center.