By Marc K. Siegel
Physicians fear that near-mindless efforts to find cost savings . . . will damage our very ability to practice.
WONDERING why the
American Medical Association came out against a public option in health reform -- that is against government-offered health insurance for every American? For this MD at least its a simple matter of learning from experience.
As a practicing internist Ive been dealing with two government insurance programs
Medicare and
Medicaid for more than two decades. Over the years Ive seen the government shrink reimbursements under first Medicaid and then Medicare -- to the point that in 2005 I finally decided that I couldnt stay in business unless I stopped taking Medicaid patients and saw no more than a few Medicare patients each day.
It was costing me more to file the Medicaid paperwork than I got back from the government. I now either charge Medicaid patients a few dollars or just see them for free.
Its getting tougher to take Medicare patients too: New drugs and new technologies are wonderful health-care tools -- but keeping current and making sure to choose the right tool uses up more and more of my time. Yet Medicares reimbursement for my efforts keeps on shrinking.
Im not alone. Each year I find I have fewer specialists to refer my Medicare patients to. The best mammographer I know no longer accepts Medicare so I find myself trying to persuade my patients to see her anyway (and pay $300-plus out of pocket) because shes so good.
Nor is this just my impression. The Medicare Payment Advisory Commission reported that 28 percent of Medicare beneficiaries looking for a primary-care physician last year had trouble finding one up from 24 percent the year before. And a survey last year by the Texas Medical Association found that only 38 percent of primary-care doctors were taking new Medicare patients. Here in New York less than half the internists affiliated with New York Presbyterian Hospital accept Medicare.
The problem is even worse with Medicaid -- which only half of physicians accept according to a 2005 Community Tracking Physician survey.
The problem is spreading to private insurers -- who often follow the lead of Medicare and Medicaid. HMOs in particular have cut reimbursements to doctors; many of my colleagues have dropped out of HMOS as a result (giving me fewer options of who to refer my patients to).
Read more HERE
*This article is from www.NYPost.com
By Marc K. Siegel
Physicians fear that near-mindless efforts to find cost savings . . . will damage our very ability to practice.
WONDERING why the American Medical Association came out against a public option in health reform -- that is against government-offered health insurance for every American? For this MD at least its a simple matter of learning from experience. 
