October 27, 2009 at 5:00 pm
· Filed under Civil Rights, Ecomonic Issues
Congress just created a crises. They were given the opportunity to remove a law that mandates a 21 percent reduction in MEDICARE and TRICARE payments that is effective in January 2010. What this means is that a physician treating a MEDICARE patient will get paid over twenty percent less that in the past. This action alone will create a major crises in American healthcare.
Most doctors are not paid enough now. I interviewed one physician who claims that he barely breaks even with MEDICARE patients. Another insisted that he actually lost money on Medicare patients, because they tend to be sicker than the average patient and need more time than the average 15 minutes he spends with other patients. Both of these doctors say that the will stop seeing Medicare patients when the reduction becomes effective.
The failure of Congress to act occurred despite lobbying by many veterans organizations, and The American Medical Association. How can our elected representatives be so dense? The concept of lowering payments to doctors assumes that:
(1) they charge unfairly high prices;
(2) they have enough financial leverage due to payments from insurance companies that they can treat seniors free of charge;
(3) the insurance companies are paying them generously and without hassle.
None of those assumptions are true. The reality is that physicians are one of the least lucrative professions, above teachers and policemen, but far behind bankers and financiers, and congress (with their extensive healthcare insurance).
One trouble with congress is that they have a short memory. Congress held extensive hearings during the 1960s into the health insurance situation for our senior citizens. Insurance companies had begun to drop policies of older Americans. Insurance companies testified that they did not want to insure seniors because their care cost too much. Finally, congress passed Medicare. It was not envisioned that Medicare would be financially profitable. Numerous times in the decades since, congress passed revisions of Medicare to cut costs. Numerous times our government revised the rules because physicians would refuse to take Medicare patients.
It is time for congress to wake up and at least sponsor a “professional” unbiased study of doctor’s fees. They will find many physicians struggle to maintain a marginally profitable business.
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Sarah Puglisi said,
November 1, 2009 @ 3:42 am
I’ve never met a single doctor that drove a car as poor as mine, or that seemed to struggle financially to the degree I have. But I guess they might. In the mess we have now, they might stop buying Mercedes and giving the appearance of making pretty good money.
I know they are denying Medicare patients, but I have apparently unfairly thought they were also furious they could not continue to make extraordinary amounts from the program. Outright corruptly in some things I’ve seen, but it has been awhile.
Even several friends of mine that are doctors are so flush in comparison to what I made. I worked ten years below 25,000 in a state that made you bankrupt at that and only in the last 6 or so have seen about 50,000 after a 27 year career that included paying for degrees, and spending quite a bit back into the classroom.That just isn’t comparable.
The phone call made to tell me I had a tumor showed up as an over 100 charge to my insurance. Just the call, and I didn’t ask for it.
I’m expected to spend and give because it’s the right thing to do as a teacher by definition. I sit in a broken chair-never have I worked any job in teaching with a chair remotely acceptable and not one doctor I ever was treated by had anything less than a nice office, furniture, technology. Perhaps they just don’t appear to be as bad off as they must be.
So my expectation is doctors should give to their elderly patients that care they need.
It’s too bad all the middlemen can’t get hit and reduced too.
The whole mess of all of it is a shame.
But I just have a hard time thinking doctors have done so poorly, that’s something I really will need to look into, my notions are so off that track. I guess I have the same erroneous assumptions.
Monte Stevens said,
November 2, 2009 @ 8:15 am
Not sure I agree with your statement that physicians are one of the least lucrative professions. As in any profession they may not make as much within their first few years but beyond that most physicians I know seem to have nice homes, cars, and take some pretty good vacations. I also make the assumption they have good incomes because of the high charges I see on bills for such short office visits. I’ve seen charges from physicians I never saw or knew while they assisted another physician during one of my surgeries.
I just had a visit last week with a new physician and as usual the 15 minutes seemed incredibly insufficient and left me feeling like I was nothing more than a number, a part of their production line for the day. He wanted to setup a followup appointment in a month because he was going to be gone for the month of November. Vacation or training?
And, I suppose we need to define what we consider a marginally profitable business, $25,000 or $250,000 a year.
This has been one of the most vocal posting I’ve read of yours. It seems to have hit a nerve and very personal. There’s been a pattern to ask questions to your readers without so much personal feelings as this one. I hope everything is okay.
Opa said,
November 3, 2009 @ 4:49 pm
Sarah, Monte,
Thank you for your thoughtful comments. Usually I get very few comments and it is tempting to think the blog is seldom read. You two cheer me. And, Monte, I am probably too heavily invested in this issue. To me providing health care (or denying care because a person can not afford insurance) is a moral issue.
Did not intend to glorify physicians, or ask people to feel sorry for them. I also know medical doctors who drive expensive cars and live in fine houses. I guess the ones that I interviewed thought they should earn more after 8-10 years of medical education and several hundred thousand dollars in student loans that need to be repaid. My reference to them being “one of the least lucrative professions” was meant to be comparative: People in “finance and investments” make much more than the average doctor, and those in government power seats (Senators, Congressmen) Make generous amounts compared to average physicians (doesn’t include specialists).
I think the real point is that many physicians who take MEDICARE, will decide to drop Medicare patients when their fees from Medicare are reduced by more than 20 percent. And if these doctors stop treating Medicare patients, where will the patients go for healthcare?
Opa
Sarah Puglisi said,
November 4, 2009 @ 8:57 pm
Of course I come read.
I enjoy it. You are fair to every issue.
I had a terrible time awhile back finding doctors to take Mom’s Medicare after her stroke. My heart doctor and my neurologist wouldn’t take her. I changed my neurologist because that offended me but the heart doctor is too good. so she got care by a Dr. I wasn’t as happy about.
My father has terrible pain resulting from four back surgeries and still no relief for pretty severe issue. It must be ridiculous pain he was always stoic and he complains-shocking me. Dad gets a little relief from physical therapy. His Cleveland Clinic Dr. writes the orders but due to regulations of Medicare he waits long periods without it and he just suffers incredibly then. It isn’t even humane.
He cannot afford it.
That just gets me something fierce.
Perhaps I get distracted by the Dr. that appeared to do well-I’m sure those entering the field face fantastic debt on loans.
I am looking from the door of an educator guaranteed to live near poverty, with my closest friend a teacher having her daughter qualify for free and reduced lunch for her daughter on her beginning teacher’s salary.
While she and I faced repayment on those loans and a job so underpaid that it is one competing with military service for people that do the right thing and literally “pay for it.”
I hope Congress doesn’t make things tougher.
I never really got around to saying that your main point was important and thanks for writing about it.
Monte Stevens said,
November 11, 2009 @ 3:15 pm
Yep, I read your blog and have you on my feeder. Whenever you post anything I should get a notice.
I agree our medical care system is in trouble. I agree with the need to take care of the ill and elderly as a moral problem. My fee is a change is needed within the pharmaceutical companies and insurance companies, not the physicians. Expecting government to fix it for us is unreal, it starts with us. Too many CEO’s make incomes and receive bonus checks that could pay for several peoples yearly premiums.
Yes, I will be here to read your posts. I need to! You help me think and analyze what my views are. I have a tendency to sit back and not get involved.
Love ya!
Emily said,
June 1, 2010 @ 12:19 am
Yep, I read your blog and have you on my feeder. Whenever you post anything I should get a notice.
I agree our medical care system is in trouble. I agree with the need to take care of the ill and elderly as a moral problem. My fee is a change is needed within the pharmaceutical companies and insurance companies, not the physicians. Expecting government to fix it for us is unreal, it starts with us. Too many CEO’s make incomes and receive bonus checks that could pay for several peoples yearly premiums.
Yes, I will be here to read your posts. I need to! You help me think and analyze what my views are. I have a tendency to sit back and not get involved.
Love ya!