Letter to the Washington Post: “There is no mystery about the findings of a Rand Corp. study that people lack access to doctors in the District. Try signing up with a doctor who will accept Medicare.
The answer will be either that the doctor will not take any more patients on Medicare, or that he or she has opted out of the program. That also applies to tests, which must be paid for at full rates. That even applies, in some cases, to private insurance. Some won’t take anything, period.
Even for ready money, it appears to be difficult to meet with a doctor to assess his or her philosophy and competence. One doctor I queried wanted $250 for a half hour of her precious time. Another would not see a new patient for a talk at all. Her minimum fee is $280 for a full medical consultation. Another’s fee — never mind competence — is upwards of $500 an hour.
Is anyone still wondering how fast these fees can mount if someone gets really ill? Is anyone still wondering why some people out there don’t have doctors? If The Post printed a list of doctors who accepted Medicare, I guarantee that the list would be short.”
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No surprise at all. The District of Columbia is one of the most expensive cities in the nation to live in or do business in. That includes the practice of medicine. Hourly office labor rates, office rents, insurance premiums and taxes are all high. Housing, food and gasoline even cost much more there than elsewhere. Only residents in places like San Francisco and Manhattan have comparable costs (except California has a lid on malpractice noneconomic damages, the District doesn’t.) Medicare rates just don’t adequately pay for the costs of services in that city. The District has a large public insurance roll that never covers the costs of its consumption, and complicated Medicare patients are now included among them. I practiced there and left out of frustration with a system that left me working harder for less money every year and with no prospect of relief in sight. The doctors who demand cash at rates that properly cover costs for their time are doing what any responsible business owner has to do to keep the doors open and fund the necessary requirements of his practice and himself.
“Anonymous : 10:49 AM” has precisely nailed it, especially given his personal experience. I fled from DC years ago.
The District of Columbia is no place to locate any business, be it a medical practice or a dry cleaners (remember the $56 million dollar pants lawsuit?).
Ed Sodaro MD
Look up the name of the author of the letter, MERYLE SECREST BEVERIDGE. This is from Amazon, describing one of her books.
“About the Author
Meryle Secrest was born and educated in Bath, England. She has written biographies of Romaine Brooks, Bernard Berenson, Kenneth Clark, Salvador Dali, and Frank Lloyd Wright. Meryle Secrest lives in Rockville, Maryland, with her husband, the composer Thomas Beveridge.”
Why do I have the feeling she looked for the equivalent of London’s Harley Street private doctors, then was shocked to find they wanted cash and would not accept government pay.
Oh, if you’re a nonparticipating or opted-out physician, and you order blood testing done at a participating lab, the lab charges Medicare rates and bills Medicare in the usual manner. You are not paying cash to the outside lab, unless you want a “Harley Street” equivalent lab. Like maybe some of the antiaging practitioners.
Or she could go back to England, and find out how well the NHS cares for their elderly.
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