Sometimes I Feel Like a Piece of Bologna

Sunday, June 24, 2007

Physicians Will Limit Patients if Medicare Cuts Payments

The Medicare funding crisis is heating up. Increasingly, I’m reading reports that physicians will stop taking Medicare patients if the government cuts Medicare payments. According to a survey conducted by the American Medical Association, 60 percent of nearly 9,000 doctors said they would limit the number of new Medicare patients they'd accept if the scheduled 10 percent payment cut is not averted.

The survey also found that if the payment cut took effect:
More than two-thirds of the doctors responding would defer the purchase of needed information technology next year.

Half would reduce their staff.

Fourteen percent would "completely get out of patient care."

Under the Medicare law, payments to doctors are supposed to be reduced to balance increases in the volume of their services. But with doctors repeatedly threatening to reduce access for elderly and disabled patients, Congress has blocked the scheduled cut every year since 2002. Because of that, this year's payment cut is scheduled to be 10 percent. Over the next nine years, the AMA estimates that the reductions would total about 40 percent, even as doctors expect their costs to increase 20 percent.

I know that when I go to Mom’s medical appointments with her, the doctor is always in a hurry, more so than my physicians. He’ll give her five to ten minutes. That’s it. Then we have to make another appointment, which is difficult since I drive four hours to be there.

This problem is serious already, and will only get worse if the pending immigration bill passes. It’s estimated that plan will cost $1.2 trillion! And yet, we can’t provide care that has already been promised to our elderly. And Gen Sandwichers, don’t count on Medicare being there when we are eligible! It’ll be broke long before that.

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3 comment(s):

My husband is a physician. He was on a salary, not dependent on the number of patients he saw. Ditto now. But to do a thorough job, his hours increased and increased, due to increasing paper work, both from insurance and medicare. And also because more people expect to be seen NOW. He finally bailed out and now works for a clinic that sees only veterans. There are definet drawbacks to that job. But he was working 60 - 90 hours/week before, and that is with having a day off in the middle of the week.

I've heard that in our state, the Medicaid payments to dental providers pays way way lower than their costs, so they limit the number of patients with Medicaid. It is understandable from a business-survival point of view.

The question is how can a doctor, or anybody, be expected to provide good complete services for less money? Sure they could cut their personal income, which maybe isn't all that high considering the number of hours they work. But there are so very many support staff at a clinic that are supported by the doctor's work. Those people have to be paid.

At my husband's former clinic, they used to contribute to pensions of the workers. They haven't had a cent left over for that in 10 years. They, like everybody else, increased the cost of health insurance to their employees, and cut other benefits.

But regarding rushed doctors, yes. They need time to be thorough, to consider all parts of a possible diagnosis. Rushing is bad medicine. And the perception of rushing contributes to patients not asking all the questions they want to ask.

I've had to be a patient often and I have seen lots of incomplete care. It makes me mad.

By Blogger P.S. an after-thought, at 5:42 AM  

Forbes magazine examined compensation in 800 different job categories. Thirteen of the top 15 are various medical specialties. In short, these are the highest paid people in America. (We're not including celebrities and professional athletes here.) Lawyers, by the way, ranked number 16 on the list.

If we ask that doctors be held to a high standard of performance in return for their top-of-the-heap compensation, that is probably appropriate. As for doctors' claims that they will leave medicine if anyone messes with what they get paid, I have to say I think a lot are bluffing. The "less compensation" being discussed here is still likely to be more than people doing any other kind of work can reasonably hope for.

By Blogger Pete, at 9:06 AM  

I won't argue that most doctors make more than most other people. But I will argue that most doctors work longer and harder and train longer than most other people.

If figured at 40 hours plus time and a half, like many people are paid, then maybe my husband's salary has been in the $ 35/hour range. That may sound good, but compare it to car repair. We got an estimate last fall for collision damage to the car. Depending on which service was listed, they were charging $50 - $75/hour. Granted, probably over half of that goes to the shop and to benefits.

How many people do you know who would work Mon, Tue, Wed, Fri for 10 hours/day, and the be on call Friday at 5:00 pm through Monday morning 8:00 am, and then start the week all over again? This schedule happened at least once/month. The other weeks, he was on call all night a night or two each week during the week. I'm not exaggerating. And yes, he finally left for a job with less money and fewer hours.

By Blogger P.S. an after-thought, at 5:34 AM  

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