28 November 2010

Doctors more reluctant to treat Medicare-funded patients

Doctors across the country [are] complaining that they've been forced to shift away from Medicare toward higher-paying, privately insured or self-paying patients in response to years of penny-pinching by Congress.

And that's not even taking into account a long-postponed rate-setting method that is on track to slash Medicare's payment rates to doctors by 23 percent Dec. 1... physicians have already been running print ads, passing out fliers to patients and flooding Capitol Hill with phone calls to convince Congress to suspend the 25 percent rate cut that the SGR method will require next year...

...government analysts and independent experts suggest that although doctors could not absorb a 25 percent fee cut, the claim that they have been inadequately compensated by Medicare until now is wildly exaggerated...

...statistics also suggest many doctors have more than made up for the erosion in the value of their Medicare fees by dramatically increasing the volume of services they provide - performing not just a greater number of tests and procedures, but also more complex versions that allow them to charge Medicare more money.

From 2000 to 2008, the volume of services per Medicare patient rose 42 percent. Some of this was because of the increasing availability of sophisticated treatments that undoubtedly save lives. Some was because of doctors practicing "defensive medicine" - ordering every conceivable test to shield themselves from malpractice lawsuits down the line...

"The argument that doctors literally can't afford to feed their kids [if they take Medicare's rates] is absurd," said Berenson. "It's just that doctors have gotten used to a certain income and lifestyle."

Regardless of their motivation, if doctors skew their patient base away from Medicare too drastically seniors' access to medical care could be limited.

Is that happening? Again, opinions vary...
Read the rest of the discussion at the Washington Post.


  1. Doctors already skew their patient base away from Medicare patients. While unemployed, a friend's pregnant wife and baby were on Medicare, and they were unable to find a local physician who was accepting new Medicare patients (they filled their quota).

    So, when something came up which would normally mean a visit to the doctor's office, the friend's wife was forced to go to the emergency room instead, at a much greater cost to the government.

    Something's wrong here. Count me as one conservative who thinks it's time to completely overhaul the system - and with more guts than congress had. The currently passed health care bill will only make things worse. They didn't have the fortitude to do what needs done.

  2. Tricare, the health insurance for military members and their families, has the same reimbursement rate as Medicare.

    Doctors will be refusing Tricare patients, too. Given a list of 40 doctors in the area accepting new patients, perhaps one or two might take a new Tricare patient.

    As for treatment on base, many military hospitals have downsized into wellness clinics, no longer seeing ER patients or delivering babies or doing surgeries, instead referring them out to the local community.

    A friend found out she had breast cancer and could not find anyone closer than 60 miles from her home to treat her. Long commutes in a snowy climate do not combine well with chemo. Her solution? $8000 cash to a local MD she respected and trusted. "I kept an emergency fund and I consider this to be an emergency".

    What of the young families- or anyone- that does not have such funds? And this tale is prior to the cuts that are coming.

    No doctor will be able to afford to treat military members and their families. What then?

  3. the medicalprofessionals will always fight a reduction in reimbursments..This has been ongoing dispite the obvious abuses of the system from both sides of the street. This is my first time visiting here..I hope to visit you often..You may enjoy one or two of my sites as well. Candela is the newest of my 4 and is political (US) and Carlsvilleproject Health.
    I would be interested to her your get your obversations and opinions.



Related Posts Plugin for WordPress, Blogger...