"Unless something changes, there will be quite substantial reductions in physician fees."

This was done because physician fees were rising faster than projected.

First, the physician fees would be set by formula to reflect the time, training and skill that a doctor needs to perform a procedure.

Yet insurers would still have the flexibility to negotiate physician fees, treatment practices and hospital reimbursement.

The report does not say specifically how the Government should set physician fees.

Despite more than $120 billion spent by the Federal Medicaid budget, physician fees are but $13 a visit.

It also received a negative report card on a program designed to help Medicare patients avoid extra physician fees.

That is why the Republicans are also planning to make huge cuts in hospital rates as well as physician fees.

And physician fees, well, that's a lot of cost as well.

Congress has voted to delay the reduction of physician fees in each calendar year since 2003.