Saturday, August 18, 2012

http://www.forbes.com/sites/aroy/2011/03/09/the-next-physician-access-problem-medicare/

This is chilling. According to Medicare actuary, Richard Foster, under the President's health-care proposal, Medicare reimbursements will actually fall BELOW those of Medicaid and it'll happen within a decade. This could (as has already been the case with Medicaid) lead to a problem of seniors having a difficult time finding primary care physicians and competent specialists (it could also lead, most unfortunately, to a sharp decline in terms of clinical outcomes - again, as has already been the case with Medicaid)....Talk about Mr. Obama sugar-coating the mother, huh?...........................................................................................................P.S. The bottom-line. No, Mr. Obama's Medicare cuts (716 billion) will not come directly out of  seniors' pockets. But they will in fact damage the program in the not too distant future and the Romney camp has every right to point that fact out. Just sayin'.

18 comments:

Jerry Critter said...

And just what is that damage?

Will "take no prisoners" Hart said...

50% of doctors currently don't take Medicaid and if the Medicare reimbursement go even lower than that, I don't even want to think about it.

BB-Idaho said...

I'm wondering if my Doctor will accept food stamps ..er gov't vouchers?

w-dervish said...

So the doctors are just going to fold up their tents and quit? I don't believe it. Overpaid doctors will have to accept slightly lower wages, that's all.

The solution is for the government to fund doctor's schooling and accept repayment via public service.

w-dervish said...

Will: they will in fact damage the program...

The "damage" will be lower profits for insurers providing medicare advantage. The money will come from those lining their pockets at taxpayer expense. I fully support it.

w-dervish said...

Single payer.

dmarks said...

Sorry, monopolies are a bad idea. We need more "payers", not fewer.

dmarks said...

And WD, if you think this has anything to do with plutocrats of any kind, nothing can be further from the truth.

For one, I think it would be an OK reform to require insurance and maybe some other parts of healthcare to be nonprofit (and remain non-government-controlled).

For another, I was and am a strong supporter of the Occupy movement's idea to take money out of the big banks and put it in local credit unions. This would be a great idea in healthcare too.

Decentralize, downsize, diversify.

The Heathen Republican said...

"So the doctors are just going to fold up their tents and quit? I don't believe it."

WD, this isn't how it works. Doctors aren't required to accept Medicare patients, and if reimbursement rates go down, more doctors will stop accepting Medicare patients.

What do you think happens to Medicare if doctors stop accepting new Medicare patients?

BB-Idaho said...

"What do you think happens to Medicare if doctors stop accepting new Medicare patients?"
We go to nurse practioners. Do those doctors 'fire' their patients when they turn 65? In our area, many doctors don't accept
anyone, let alone the elderly..there is a shortage here.
There will be newer, young doctors, altruistic ones who will
be glad to accept medicare patients. It is a huge business:
"The elderly (age 65 and over) made up around 13 percent of the U.S. population in 2002, but they consumed 36 percent of total U.S. personal health care expenses."
"In 2001, 5 percent of Medicare fee-for-service beneficiaries accounted for 43 percent of total spending, with 25 percent accounting for 85 percent of all spending." source
I can see if physicians are full
up, they cannot take any more patients. If they choose to reject
'up to 85% of all spending...they
must be cosmetic surgeons..cutting off their noses to spite their faces.

w-dervish said...

HR: WD, this isn't how it works.

It is. There will still be profit to be made. If some doctors don't want that profit, others will step in and claim it. I agree with what BB-Idaho said.

Get rid of the greedy doctors who are used to be overpaid and make way for the doctors willing to make a reasonable profit and be paid a fair wage.

Will "take no prisoners" Hart said...

wd, uninformed per usual. a) Fully a third of Mr. Obama's 716 billion in cuts goes to low-balling doctors and providers. 50% of doctors today don't accept Medicaid and if the Medicare reimbursements fall even below that then it doesn't take a rocket scientist to figure out what will happen next (and, no, doctors won't "fold up their tents and quit', they'll just accept private insurance patients or people who pay in cash). b) This assertion that Medicare Advantage is more costly than regular Medicare is a falsehood. Yes, it costs more but when you factor in the additional services that Medicare Advantage provides, the end result is a more economical/bang for the buck situation. c) Canada and England have single-payer. Germany and Switzerland don't. Where would you rather live if you were sick?

Will "take no prisoners" Hart said...

BB Idaho, I'm a strong supporter of nurse practitioners and would have absolutely no qualms about seeing one. Unfortunately, in a lot of states these people have to be under a doctor in order to practice (it's almost like a medical cartel) and so I'm not entirely certain how quickly a transition could take effect regarding that.......This is what I wrote a few months back on this - http://paranoiacstoogetalk.blogspot.com/2012/02/cartel-unquestioned.html

w-dervish said...

It's only "lowballing" to doctors used to making exorbitant salaries, or hospitals who think they should be making huge profits. Doctors have long been overpaid and time to do something about that.

Will: ...if the Medicare reimbursements fall even below that then it doesn't take a rocket scientist to figure out what will happen next.

How many patients can doctors afford to not accept? I say these greedy docs need to get with the program and accept making a little less profit.

Will "take no prisoners" Hart said...

If doctors had to only accept Medicaid and and an even lower remittance rate on Medicare, they would fully go out of business, wd. Is that what you want? And not all doctors are overpaid. General practitioners like my doctor are barely getting by and who in the hell are you to say that anybody is overpaid. It takes 11-12 years to bee a doctor and after they pay for their student loans and malpractice, I don't have a problem with them making some money. And what hospitals are you fucking talking about? A lot of inner city hospitals are barely hanging on.

w-dervish said...

Will: If doctors had to only accept Medicaid and and an even lower remittance rate on Medicare, they would fully go out of business, wd. Is that what you want?

Absolutely not, but if they choose to quit their business that is their right.

Will: ...who in the hell are you to say that anybody is overpaid.

I was referring to the study I linked to in my comment that comparred the salaries of US doctors to the salaries of non-US doctors. When that comparrison is made it shows that US doctors are overpaid.

Will "take no prisoners" Hart said...

Or that European doctors (who may not have the expenses that American doctors do) are underpaid.

w-dervish said...

dmarks: Sorry, monopolies are a bad idea.

I'm glad you changed your mind and now agree that we should break up the big financial institutions.

Will: Or that European doctors (who may not have the expenses that American doctors do) are underpaid.

This is further proof of your wealthy worshiping tendencies. You advocate for cutting the pay of lower and middle class workers, but when it comes to those whose wages are already high: you want them to be higher.

And the answer to your question is "no". According to the study, "incomes of primary care doctors and orthopedic surgeons were substantially higher in the United States than in other countries. Moreover, it said, the difference results mainly from higher fees, NOT FROM HIGHER COSTS of the doctors' medical practice, a larger number or volume of services or higher medical school tuition".