My take: Medicare, balance billing, me, op-eds

Some pre-holiday takes readers have asked me about.

Here’s my take on . . .

1) . . . the Medicare cuts:
Next week is going to be an interesting week. My guess is that the Senate will hammer out something to avoid the 10% physician payment cuts. The question is, will the Republicans take money away from the Medicare Advantage plans? And will the President veto the bill? I think the answers will be yes and maybe. The Democrats have grown some balls and will play tough.

So far, the Republicans have done all they can to hurt physicians – I’m sure this debacle has caused a few to cross over party lines.

Part of me wants to see the cuts go through. With physicians dropping Medicare left and right, the AARP will go ape. It will be the closest thing we can get to a strike. Maybe then the politicians will recognize the value of physician access and do something about the payment system. Sometimes it takes a crisis to affect change.

2) . . . the lawsuit against balance billing in California:
I just received a $2,000 bill from my dentist for costs not covered by my dental insurance. There should be no reason why doctors and hospitals can’t do the same.

3) . . . why I don’t write more original pieces:
Time. My day consists of seeing 25+ primary care patients, sifting through 100+ blogs and newspapers for interesting links, and spending time with my family. Writing a polished op-ed takes me about 3-5 days. So, if I write more original pieces, my patients, blog, and family will suffer. Can’t have everything.

I’d like nothing more than to spend more time writing, but alas, it doesn’t pay the bills.

4) . . . why I didn’t publish your link:
I receive about 50+ e-mails per day asking me to link, mention, or endorse a site, book, blog, or product. I link to what I think is interesting, and it’s a completely subjective process. If you don’t like it, well, you can start your own blog.

In general, I prefer links to pieces that are well-written, easy to read, and takes a somewhat balanced, measured tone.

I can’t post everything I receive, so I apologize in advance if I can’t publish your link.

5). . . how to get an op-ed published in the newspaper:
I’ve been fortunate to have a few printed. I learned everything I know from Googling “How to write an op-ed“. Here’s a handy list of contacts for the major American newspapers.

If you get rejected, don’t despair. Often times it’s a matter of timing. Try submitting it to another publication.

That’s it for now. I’ll be taking the weekend off, but there will be a Reader Take by Dr. Leap. If you’re in Boston, you can catch me at Chowderfest on Sunday. Mmm . . . chowda.

Happy Fourth, and a belated happy First to my fellow Canadians.

Want my take? E-mail a topic or question you want me to blog about. Selected entries will be posted in the regular “My Takes” feature.

Comments are moderated before they are published. Please read the comment policy.

  • maggiem


    People actually ask you why you don’t write more posts?

    I can’t imagine how physician-bloggers do it. How do they find the time? I can only hope that blogging is cathartic. Physician bloggers make a very important contribution to the national health care discussion. I don’t always agree, but they are “inside,” and know what’s going on.

    Next week will be extremely interesting. Nice to see that the Democrats have, as you say, “grown balls.” But my guess is that if they pass a bill that cuts the insurers’ windfall, Bush will veto it. We’ll see . . .

    Even if Bush vetos, in 2009, Congress will slash the bonus to insurers, and we can be pretty sure the president won’t veto. (Even if McCain takes the White House, he is, as you probably know, one of very few Republicans who voted against the Medicare bill that created Medicare Advantage.)

  • Christian Sinclair, MD

    Thanks for your work Kevin. I like these posts with your short opinions and the reader takes are good as well.

    It is nice to look at the man behind the curtain every once in a while and realize that you get email and links from many many different people.

    Thanks again and have a good holiday weekend!

  • DrVal

    Happy 1st (raised a glass at the Canadian embassy on Tuesday and got a temporary flag tattooed on my face). And Happy 4th as well… I am a dual citizen after all. ;)

  • Robin

    I enjoy your writing. Food for thought. I did question, though, this comment: “. . . the lawsuit against balance billing in California:
    I just received a $2,000 bill from my dentist for costs not covered by my dental insurance. There should be no reason why doctors and hospitals can’t do the same.”

    I thought they did. My hospital and my doctors do. Secondly, I wish my health insurance was a cheap as my dental insurance.

    Have a wonderful weekend.

  • AD

    I agree on the concept of balanced billing, however it is hard to muster up any sympathy for it the way things currently are. Hospital billing is not transparent in any way. The “billed” price and the agreed upon or accepted price between the multitude of insures are vastly different. When a hospital bills out $10 for an aspirin, $200 for a bag of IVF and $5000 for a CT scan they are not going to find many people sympathetic.

    The guy who runs this hospital chain is known as a real A**. He is a physician who has put all human decency aside to become as rich as he can be.

    Like many things a few bad apples ruin the whold box. Too bad because the option of balance billing is the only leverage we have against insurers that want to pay nothing for services and treatment already rendered.

    This guy who

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