Almost 30 percent of Medicare beneficiaries have trouble finding a new primary care doctor.
Expect that number to rise dramatically in the near future, as the number of Medicare beneficiaries balloons, and the amount of primary care physicians plummets.
The whole scenario is a perfect example of how poor physician access makes medical coverage practically worthless.
Contrary to popular belief, Medicare’s paperwork requirements and pre-authorization obstacles are just an onerous as those of private insurers. Combined with the continuing threat of downward physician reimbursements, and the baseline complexity of a typical Medicare patient, it is no wonder that doctors are dropping Medicare in droves.
This phenomenon with Medicare is likely going to spread nationwide, if the current plans for universal coverage go through without first addressing the primary care shortage.
Related posts:
- Finding a doctor who accepts Medicare
- When primary care refuses to accept Medicare
- Primary care and the elderly
- Primary care-specialty income gap: It’s worse than we think
- How to drive a doctor out of primary care
- "We have to make primary care a more attractive profession"
- How the primary care doctor shortage threatens Obama’s health reform plan
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Permanent Medicare physician payment reform is needed to ensure that physicians can care for Medicare patients. AMA Board Chair Dr. Joseph Heyman writes in today’s New York Times that “Congress has a unique opportunity this year — with a 21 percent pay cut planned for 2010 — to solve the problem and ensure that physicians are able to care for current and future generations of the elderly.”
Read the full letter to the editor at http://www.nytimes.com/2009/04/08/opinion/l08medicare.html
What constitutes “having trouble”? For that matter what constitutes “a shortage” of primary care physicians?
Until these terms/phrases are actually defined, they are meaningless.
By the time I retire, I see Medicare & health insurance being replaced by concierge health coverage.
If it is true that 68% of all Medicare patients have 5 or more chronic diseases, there is no way for Medicare or for the health insurance industry to survive if they keep paying out the way they do. They have to continue to cut as more baby boomers become eligible for Medicare.
Finding a new doctor is already an obstacle for some. This story below talks about the impact of closures on the very ill.
http://www.cbsnews.com/stories/2009/04/03/60minutes/main4917055.shtml
I closed my primary care medical office in 2001 because Medicare didn’t pay enough for me to keep it open.
I became a hospitalist and tripled my take-home pay. And I’m not the only one who left office practice. There are thousands of us.
The politicians are well aware of what they are doing to primary care.
When enough of their consituents (the patients) complain, things will change in one of two ways: 1) pay docs enough to make a fair profit, or 2) involuntary servitude by physicians via socialized medicine.
Anyone else hear that flushing sound?
From a meeting with Zeke Emanuael who is leading Obama’s healthcare reform team, we learned Obama’s intention. Although the plan is still on the drawing board, the Obama administration has told the AMA that it will uphold the 21% Medicare cut in January if physcians do not hold the line on one of their main principles. That is the Obama administration wants to reduce the healthcare expenditures that occur in the last years and months of life. To do this they want to have a board that will determine what they consider to be “futile treatments” very similiar to the boards in Europe that restrict dialysis, chemotherapy, CABG etc, and the treatment of pneumonia in the elderly. In a sense they want to cut healthcare costs by cutting care and want to decrease Social Security costs by reducing care to those that are old enough to collect. They want to do this not only with government funded programs but all healthcare payors as a part of a larger universal health plan.
Guys, this is your chance to make a clean break from your existing payment model. I know it’s worked well over the years, resulting in you being the highest paid profession in the world, but it’s about to cost you big.
Take the leap, jump back into the free market that every other professional deals with. Bill your clients directly. Try hourly, try flat fee, try any number of things until you get comfortable with it. But do not horse trade with the government. There is too much of an imbalance in bargaining position at this time. It is a loser for you.
Stop screaming “crisis” about everything in medicine, which opens the door for them to come in and fix “the healthcare system”. You’re professionals providing a service to individual members of the public. If you keep thinking of yourselves as cogs in a wheel, then you’re going to be treated that way. You’re not, and I’ll say it again: You’re professionals providing a service to the public. Just like engineers, accountants, lawyers, and architects. There is no “accounting system” that the government is about to take over. No “architect system” wholly funded by the feds.
Step back, take a breath, and save yourselves. Before it’s too late.
“That is the Obama administration wants to reduce the healthcare expenditures that occur in the last years and months of life.”
Is this supposed to be a bad thing? There are a lot of annoying things in our health care system, but possibly the worst is the way we blithely throw around 50,000 dollar operations on people we know will be dead in six months. The current system has no incentive against massive overtreatment. This is the only Obama health care proposal I LIKE.
“Is this supposed to be a bad thing? There are a lot of annoying things in our health care system, but possibly the worst is the way we blithely throw around 50,000 dollar operations on people we know will be dead in six months”
On the face of it, it may sound like a good thing. The devil is in the details. Do you really want some faceless government entity telling you that “sorry, you child has relapsed neuroblastoma” and our algorithm states he most likely will be dead in X months so he is going into hospice today. End of story. What is your response to that scenario with your child?
Universal coverage makes sense for "K to 12 medical care" e.g. all kids should have access to immunizations regardless of their parents ability to pay. This prevents epidemics which affect the whole population. Appendectomy in a young person let's that person go on to lead a productive life. I think the state of Oregon has already come up with an evidence based cost/per life year saved A to Z payment list. What does NOT make sense is paying for everyone who has survived to 65's complete end of life care, other than hospice, including a pacemaker $10,000 in a person with advanced Alzheimer's disease! This should be available only to those with private funding or secondary insurance. In reality, health insurance is probably not needed for routine primary care, but you have to help people plan for a rainy day. Disease insurance is needed really for hospitalization and surgery. (think auto maintenace and car insurance). The final plan if we decide on one, needs to incorporate personal responsibility. Patiens with a BMI > 30, or who smoke will HAVE to pay a higher premimums. We have enough evidence to assign increased risk to these behaviors so they should no longer be viewed as "a peresonal choice" since they impact the cost of care you will need later.
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