Posted on 06/26/2010 8:18:11 AM PDT by iowamark
Not long ago, a close friend called me with an unusual request. She and her husband were looking for a new doctor to take care of them. What made it unusual was that they'd had the same doctor for years -- decades, actually.
What happened to "J," I asked. Did I miss something in my otherwise careful reading of the obits? Had he hung up his stethoscope?
None of the above. Her husband had turned 65 and was now eligible for Medicare. Good news -- except "J" is one of the increasing number of doctors who aren't taking "new" Medicare patients, or even old ones.
I remember the days when the health insurance industry used to advertise that Hillary Clinton would take your doctor away. She didn't. But a lot of people have lost their doctors anyway because of the PPO rules and, lately, because doctors just don't want to put up with the rates Medicare pays.
According to the Centers for Medicare and Medicaid Services, 97 percent of the doctors in America accept Medicare. But that is a very deceptive number. It doesn't mean that doctors will take new Medicare patients. According to another study, this one by the American Medical Association, 17 percent of the doctors they surveyed restrict the number of Medicare patients in their practices -- and that number for primary care physicians is 31 percent. Watch out!
Some doctors get around the Medicare limits by charging for "concierge" service. I kid you not. They charge an upfront fee for doing things like promptly returning your calls and providing top-notch referrals, things my own doctor (not a concierge) calls good medicine. Others just get rid of longtime patients when they turn 65.
In an era of double-digit unemployment, it's hard to feel sorry for people making six-figure incomes. On the other hand, many people who do work of lesser value -- that required much less education -- make far more.
I was looking at a hospital bill of my own (from when I collapsed on a street corner in New York City), and frankly, I was pretty horrified to discover that the doctor who read my brain scan and concluded that, thank God, there was no mass was paid less than the hairdresser who trims my hair. Don't get me wrong: I like my hairdresser and value his work. But my life doesn't depend on it.
And the doctor got more from my insurance company than he or she would have received from Medicare. I have private insurance. Doctors get paid, on average, 22 percent less from Medicare than they do from private carriers. And they're prohibited by law from billing you the difference.
Obviously, we need to do something -- actually, many things -- to rein in the skyrocketing costs of health care. As more of us get older and the number of uninsured decreases, those costs are only going to increase. But simply paying doctors less to do their jobs is not the answer.
Better prevention, better screening, fewer unnecessary tests and procedures, more coordination -- all of those are important steps. But there is something wrong when people like my friends reach their 60s and have to find new doctors because the ones who know them best won't take care of them anymore.
I told my friend to call my doctor, Larry. He's watching his income being slashed, but he's past caring. He is what another doctor friend of mine calls a "dinosaur" -- a doctor who puts patients first, even at his own expense, which is how things work today. I am grateful to have a dinosaur on my side. But I fear that his ilk is facing extinction, and we will all suffer for it.
Fact of life Drs made a killing on Medicare over the years
“An amazingly honest essay by Ms Estrich.”
Yes and no. This statement seems particularly dishonest:
“I remember the days when the health insurance industry used to advertise that Hillary Clinton would take your doctor away. She didn’t.”
Of course she didn’t, because HillaryCare went down in flames. Estrich is delusional to think that plan would have played out any differently than other versions of government run health care, be they labeled “Medicare” or “ObamaCare.” When the government gets control, declining access and quality inevitably follow.
So kudos to Ms. Estrich for recognizing what’s actually happening to our nation’s largest single-payer health plan. But shame on her for not recognizing or conceding that HillaryCare was simply single payer in sheep’s clothing.
“Her husband had turned 65 and was now eligible for Medicare. Good news...”
Wahoo! More government handouts, benefits, entitlements, and subsidies for Socialized Seasoned Citizens! Who says Socialism doesn’t work?
When I see my doctor bills and how much smaller is the payment from Medicare, I am surprised my doctor has not kicked me out.
Example: Office visit with medium length consultation is $145,
Medicare approved payment $42. That is all I am obligated to pay
if I have not met my annual Medicare deductible, which is usually true since I need very few visits to the doctor.
After meeting my deductible, the doctor still gets only $42.
I almost feel guilty walking out of her office.
your ‘facts’ are screwed up
Maybe those who abused the system did- double billing, billing services never provided, billing for unnecessary tests, etc. It would be interesting to know the extent of that abuse.
I am happy that I never had you for a patient.
nobama care: Stay well or DIE, Citizen!!!!!! (that is if we don’t abort you before you are born)
Irony of ironies, Obama may go down in history as the US president who *ended* socialized medicine.
First of all, Medicare, Medicaid and Obamacare are not mathematically sustainable. But this didn’t prevent the socialists from finally forcing socialized medicine down our throats. However, to do so, they had to kill Medicare. Well, they have done that as well. Medicare is withering on the vine.
They wanted to force Medicare patients into Obamacare. But there is a serious window in the timetable when they will have neither Medicare nor Obamacare. And this matters.
Because Obamacare is loaded with “poison pills”, so it will almost certainly be thrown out in its entirety by the Supreme Court.
This means the new, *Republican* congress can either recreate Medicare from scratch, or just by doing nothing, people will have to go back to paying for their own medical care. Granted, at half the cost of government provided care, and no way the insurance companies can pay for it.
And even if the Republicans buckle under ceaseless assault by the socialists and RINOs, it won’t matter, because there will be no way to pay for a reanimated Medicare. It just can’t be done.
So as a nation, at least as far as health care goes, we have an abrupt return to a free market.
From what I could tell, most of the most famouse Medicare frauds were done by criminals. They set up fake clinics, and billed Medicare with stolen identities.
“nobama care: Stay well or DIE, Citizen!!!!!! (that is if we don’t abort you before you are born)”
Or euthanize you later...
I remember about 10 years ago he saw a sign advertising manicures. He said women pay more to have their nails done than medicare reimburses for an office visit.....BTW it was $15.00 for a complete set of nails.
...eh, you left out the most important step Susan...Tort Reform.
Medicare patients usually need the most time, because they are older, and have more health issues.
When Medicare pays so little, you lose money each time you see a Medicare patient.
It is easier to see younger patients, who usually have only one problem at a time, and get paid more by private insurance.
Huh? You mean like VA DR’s got rich?
Can someone simply pay cash to a doctor in such a situation?
LOL You're darned right, Susan. You're head is empty - full of air.
Now that you've identified the problem what will you do about it?
You at least read the bill so you know what is going on.
Many people don’t, they see, oh, it’s $1000 for this scan and think the doctor is rich. They never realize the guy gets only a hundred and change. It makes for bad relations.
Also, when someone NOT on Medicare goes for the same test, they have to pay an arm and a leg. It’s really down to the core unfair.
“Irony of ironies, Obama may go down in history as the US president who *ended* socialized medicine.”
If the Baby Boomers get their GeriCare(TM) cut off will they riot like the Greeks?
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