Cuts in physician payment = patients lose

How patients are the ultimate losers whenever physician payment rates are cut. Take a close look at Medi-Cal, and you get a sense of where Medicare is headed:

Reimbursement rates, doctors say, already are so low that a patient office visit nets only $24. Some clinics say the numbers simply don’t work anymore. The result: Thousands of patients guaranteed healthcare under state law can’t get in to a doctor’s office, so they don’t go or they sit for hours in an emergency room.

Experts warn that things may get much worse.

Pete Stark, doctors have called your bluff.

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  • jb

    When the govt wants to make sure poor folks don’t go hungry, they give out food stamps that pay grocery stores 100 cents on the dollar. When they want to build low income housing, the contractors that do the work get the full payment specified in the contract. When medical care is needed for poor folks, the docs are paid pennies on the dollar.

    The result:
    Food stores have signs stating that they are happy to take food stamps for purchases, and poor folks tend to be obese. Very few people are homeless, and those are generally complicated by psychiatric illness or substance abuse. Poor people with serious medical problems can not find medical care, because providers can’t afford to take care of them.

    They can either make it so that we at least break even taking care of the poor, or take away the nearly overwhelming documentation and liability costs of providing for them. Or they can wait in line…

  • Anonymous

    The problem for physicians is that every time something “hurts” them they cry “patients lose” as if they actually care.

    Taking care of the poor under any circumstance in nearly every facet of their lives is not terribly profitable, and no matter what happens physicians won’t be stampeding into caring for them.

  • Anonymous

    “Taking care of the poor under any circumstance in nearly every facet of their lives is not terribly profitable…”

    You are of course quite right. That being said, when doctors treating the poor are losing money, rather than breaking even, there is a certain disincentive. A derisory payment for service rendered is an insult, and as such is quite rightly refused.

    Many doctors are charitable, and will give free medical care by donating their time. Offering them pennies on the dollar for the majority of their patients is not a way to reward charity, but rather, cheapens it.

  • Anonymous

    This is a crushing blow to California ERs, and will close down many of them. I am sure a creep like Pete Stark, safe with his golden healthcare coverage in Congress, is greatly pleased with his fine work.

  • Anonymous

    Anon 11:02
    Exactly right

  • Anonymous

    “Offering them pennies on the dollar for the majority of their patients is not a way to reward charity, but rather, cheapens it.”

    The next time a physician turns down a dollar will be the first.

  • Anonymous

    “The next time a physician turns down a dollar will be the first.”

    My apologies, but if you read the article cited, it appears that physicians are in fact turning down the payment offered by MediCal for services rendered. I thought that was clear.

    In doing so, the physicians are opting out of a system that does not work. That is the only redress they have. Surely you would be displeased if your employer announced a 10% cut in pay? It would be your right to seek more profitable avenues for your skills. This is precisely what the physicians are doing.

    There is no other solution available to the doctors who would care for the poor, other than watch their business die in slow motion, and therein lies the tragedy.

  • Anonymous

    “The next time a physician turns down a dollar will be the first.”

    Not so.

    When I was last in private practice, Medicaid patients were 1/3 of my inpatient practice–and I just wrote it off without billing because the system was itself demeaning to my professionalism and the reimbursement rates insulting. In taking zero payment, I at least preserved my dignity.

    I know a great many physicians who still do that–treat the Medicaid patients that come to their service and just write it off without billing.

  • Anonymous

    “Taking care of the poor under any circumstance in nearly every facet of their lives is not terribly profitable…”

    The other problem is that with Medicare and the private plans that simply follow Medicare’s lead I get to take care of the rich for the same low compensation as the poor. We do not need to limit this to the poor, as it increasingly applies to all patients. In fact, many of the poor pay cash and actually always pay better than Medicaid.

  • Anonymous

    I didn’t even bother signing up with Medicaid.

    When I get a Medicaid patient I just don’t bother billing. It’s not worth the effort.

  • Happyman

    so true, as far as the rich. Those patients, even MILLIONAIRES, who have the standard commercial insurance plans (aetna, cigna, & especially oxford & blue cross) are the WORST patients –

    1- lowest payments from insurers

    2- least likely to pay copays

    3- most likely to call after-hours for stupid things (“generics don’t work on me, because i’m special, so you need to call the pharmacist STAT – oh, and can you call in some antibiotics for my husband too, even though you’ve never seen him?”)

    etc.