NYT: Doctors Objecting to Planned Cut in Medicare Fees

[DeepModem Mom]

Doctors Objecting to Planned Cut in Medicare Fees
By ROBERT PEAR
Published: November 20, 2005


WASHINGTON, Nov. 19 - The Bush administration is headed for a clash with the nation's doctors over a federal plan to cut their Medicare fees by 4.4 percent next year, even as the government tries to measure the quality of care they provide.

Doctors say that if the cut occurs, some physicians will be less willing to accept new Medicare patients.

Administration officials said that on Monday they would publish a final rule cutting 4.4 percent from the amount paid to doctors for each service provided to Medicare patients in 2006. They said the cut was required by a formula in the Medicare law. But doctors pointed out that President Bush had not proposed any specific legislation to avert the cut.

In a report to Congress in April, Medicare's trustees said the formula would produce cuts totaling roughly 25 percent from 2006 to 2011, while doctors' costs are expected to rise 15 percent.

Administration officials said any increase in doctors' fees would lead to steeper increases in premiums charged to beneficiaries. Moreover, they said, doctors often respond to such cuts by performing more services, so their income does not necessarily fall. Finally, the administration said, doctors should not be paid more unless they cooperate with a federal effort to measure the quality of care they provide....


http://www.nytimes.com/2005/11/20/national/20docs.html?oref=login

[bleedingheart]

1. Well since they supported Republican Medical Tort Reform...

they should be able to absorb the lost revenue they will experience as a result...


:sarcasm:

[Mojorabbit]

17. That is a crock

My husband is a family physician and we are not wealthy. We employ three people with a good salary, have an office mortgage, huge malpractice insurance costs, have to buy supplies and equipment, and he treats a whole lot of people for free as well as makes house calls to the elderly who can't get out. He was not for tort reform, he is a liberal, and he did not go into medicine for the money. After the overhead and taxes there is not a large amt left.It took us fifteen years to pay off his medical school loans and we scraped by for a lot of years.
My BIL who works for a food service company in management makes more than my husband does.

[Bread and Circus]

19. I'm a family doctor too and your situation is about the same

as mine.

Too bad many people on DU think doctors are just a bunch of greedy fatcats. Many doctors are, but that's true of all professions. Many of us are just trying to make a living for our family and do some good for people along the way.

[Bread and Circus]

20. and as for the medicare pay cut I say meh...

I don't like it (who likes a pay cut) but its not that big of a deal. I will still accept new medicare patients.

Either way though, our medical system is FUBAR

[spotbird]

27. The perception of doctors here and elsewhere is well deserved

If doctors demanded accountability within their profession rather than work to limit the only regulatory avenue left to punish quacks they would be better respected. If the professional organizations which represent the majority of doctors would also consider patients interests and end their myopic support of all things Republican physicians would be better respected.

You have a good job with tons of security, so stop your whining because you chose a specialty which won't make you rich. Many people who are equally well-educated will never enjoy job security and a reasonable standard of living.

[RazzleDazzle]

30. I agree, for the most part

While I have some sympathy for the DU members are doctors and who've weighed in, they need to understand that their profession deserves the drumming it takes here and elsewhere. If they care, they need to do what they can to change the profession itself so that the criticism is no longer warranted, rather than just complain that they themselves as individuals aren't like the other guys.

Because those other guys are killing us. Literally and figuratively.

[CountAllVotes]

34. Because those other guys are killing us. Literally and figuratively.

*ding* *ding* *ding*

Yes, that is exactly what happened to me, I almost died because of their ineptitude and complete failure to acknowledge me as a patient, much less a human being.

They got their job alright.

However, those that went to schools like Vanderbilt and Stanford maybe aren't getting the pay-offs they'd hoped to get as a doctor.

HAHAHAHAHAHAHAAAAAA!!! :nopity:

[RazzleDazzle]

37. wow. That sounds like a story worth hearing

In the meantime, you're not alone, you probably already know:

Medical system is leading cause of death and injury in US
http://www.newmediaexplorer.org/sepp/2003/10/29/medical_system_is_leading_cause_of_death_and_injury_in_us.htm

US leads way in medical errors: study
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x1897423

WP,pg1: Data Show Scourge of Hospital Infections
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x1624277

[CountAllVotes]

38. ok I'll bite

How would you like it if two doctors, both with their bills paid in full, knew that you had a tumor (cancer?) and they did not even bother to tell you about it? How is that for INCOMPETENT?

So maybe it can now be understood as to why I have :nopity: for any of these greed mongers called "doctors". Far too many of these "doctors" are nothing more than corrupt and self-serving and the only reason they go into the field of medicine boils down to one word MONEY. So I don't care if their payments get cut being they have FAILED me obviously! I wonder how many more there are out there like "me", coined as being insignificant and unworthy of proper care and attention because I happen to be on Medicare whether I like it or not?

Answer: Probably more than you or I will never know. :(

:grr:

[bleedingheart]

22. in my community it is divided...the doctors who pushed for

tort reform and those who saw the Bushistas for what they were...my pediatrician and my own MD are all solid liberals...but they were very upset with the professional groups for supporting the Bushies..

What I find funny is that doctors are clamoring against cuts when the AMA was originally against the creation of Medicare...

[spotbird]

26. Your husband needs to change specialties

It is the rare cardiologist who isn't wealthy.

Also, your husband needs to become active in the AMA which blindly supports policies which hurt your husband's bottom line.

[OzarkDem]

44. Agree, they don't understand consequences

of putting conservatives in charge of health care policy in the US. They also fail to make the connection between their rising reimbursement rates and the subsequent cutting of eligibility and/or benefits for Medicaid and Medicare.

[cap]

2. yet another technique to get rid of medicare...

sneaking in the back door.

This affects all of us.

[Mend]

3. Doctors (and I am one) have taken more crap than any other

profession. If you think we deserve it, so be it. Many smart young people are choosing other professions. If I had it to do over, I would have done something else, although I am very proud of my contributions and have never been sued. Those of us who studied hard, made it into medical school and through all the exams and the endless work load, have the brains and the will-power to succeed in other careers and I would advise any young person today to think twice about this one. Sad because practicing medicine is glorious but the surrounding bullshit is hell.

[goforit]

5. Yep!!!.....And these stupid morons in Washington know better???

They all should be fired or behind bars.

The maffia rules. And it sucks!

[DeepModem Mom]

7. I think you're right, Mend, and I thank you for this post.

The doctors who've treated me and my family have all been people such as yourself: dedicated, caring, overworked, and unsupportive of policies such as those of the Bush administration which are harmful to people. I know there are doctors who don't fit this description, just as there are bad apples in any profession, but I don't think they constitute a majority of the medical profession.

[Mend]

9. thanks for the kind words...it gets discouraging...and a bunch of

us are Democrats too.

[area51]

10. What DeepModem Mom said.

This nazi administration wants to make sure only the wealthiest can afford a doctor's care.

[kineneb]

14. we love you guys

Hubby & I appreciate all the doctors that have made his continued existence possible. Without the federal and state programs, he would have been dead by now, from renal failure.

[spotbird]

28. Medical schools are still very selective.

The martyr complex of the physicians here is laughable. Too bad you joined the profession after the gravy train passed the general practitioners stop. It may shock you that other people studied hard and worked endless hours to have much less than you.

Grow-up, be grateful for how much you have.

[RazzleDazzle]

31. Careful, Doc

A lot of people work in professions and careers that have been totally decimated by outsourcing. There are people who've been UNEMPLOYED for YEARS who have been severely affected by US economic and trade policies over the last decade or so.

You don't face anything close to that problem. Your profession may take a lot of crap, but it's definitely not "more than any other."

[goforit]

4. Meanwhile the OIL companies reak havoc over the country w/Profits!

[bmbmd]

6. Oh-I can tolerate another medicare cut.

I can't tolerate the new list of approved abbreviations.

[Sgent]

8. Just so you know

Hospitals are getting another 4-5% increase in reimbursement, since they are not under Part B.

Of course, since all the neurosurgeons have dropped outpatient Medicare in my area, good luck if you have back pain, or a brain tumor... I expect more specialists to follow suit -- many have already eliminated as much as possible.

[CountAllVotes]

11. Doctors around here are playing all kinds of games

and I'm sorry but I really do not have much sympathy for these "poor me" and "I need to eat too" doctors! :nopity: Bunch of crooks IMO; few and far between seem to go into medicine for actually caring to be something called a doctor. People? Huh?

What a shame it is for THEM? What about the person on Medicare that is paying $4,000.00 a year for supplemental health insurance that isn't worth crap in addition to Medicare payments soon to be $85.00+ a month?

Sympathy? HELL NO WE NEED REFORM!

:kick:

[Mountainman]

13. You are very ignorant of what you speak!

[CountAllVotes]

24. so you think Medicare fraud is ok I take it?

That is what is going on where I live and I resent it greatly and no I am far from being "ignorant".

[Mountainman]

33. Where did I say I agree with fraud? Stay on the topic!

I'm telling you like it is where I work. Your picture just doens't reflect reality. You seem to have an axe to grind!

[Mountainman]

12. Many DUers do not understand what this means. I am a controller of

a medical clinic and surgery center. Almost all of our patients are Medicare and Medical. We are in an undeserved area. Most of the employees here haven't had a raise in over 5 years. It is near impossible to run this place on what we get paid by those programs. Doctors get paid a percentage if the cash income they generate. If Medicare gets cut so does their pay. They have to work longer and longer hours to make the same money. Every time there is a cut it squeezes us more. Soon we may not be able to stay open.

Medicine as practiced here is not a wealth generating proposition. It ia more like people doing what they can for those who need it.

Any DUer that thinks the doctors are making money unfairly don't know what they are talking about.

[Seedersandleechers]

15. As a nurse working for an indigent hospital I agree. Although,

i wish more doc's would support national health benefits.

[badgervan]

32. National Health Care a Matter of Time.....Not If, But When

I too wish that more docs would band together and speak out, loudly and repeatedly, for national health care - things could not possibly be worse for them, or for us, than they are under the present for-profit system.
I am a disabled vet, and recently had a mini-stroke. 2 days hospital cost alone: 15,000. Other costs: 3000 and counting. I was nowhere near a vet's hospital, so had to go to local hospital. Luckily, I had Medicare, which covered about 90% of this. 2 needed drugs were not available through VA, and they are 150.00 each - which I simply cannot afford. After using up the samples kindly provided by neurologist, I am going without the 2 anti-stroke drugs that I should be taking. I tell you this to show how screwed up our health care system is. And if I were not a wartime vet, I would be going without the other 4 drugs that I get through the VA.
It isn't the fault of the physicians, but I believe that they should be pushing, and pushing hard, for a national health care plan. Sooner or later, we will have it in the U.S. - I am hoping that it is sooner.
The HMO's and Big Pharma are literally killing people, and our doctors and other health care pros could bring about huge changes - if they had the will and the desire to change the system.

[Mend]

16. I went to medical school in 1964 as the only woman in my class..

I was very idealistic. We performed to meet the exacting standards of our superiors and our peers. There was no malpractice, no medicare, no managed care. During training (I earned $4800 a year as an intern at Bellevue) we cared for everyone as they came in. Then in practice, 30% for free. If you think you can fix the system, go ahead. The best and the brightest young people may just be deciding it isn't worth it. Our son is getting his PhD in Chemical Engineering for one example....he saw my life and said no way.

[FlaGranny]

18. You must be

close to my age. In my experience, those were different times - before managed care and before incorporation. I always found medical insurance and health care much more easily come by in those days.

For comparison, the cost of a hospital room was approximately the same as an average motel/hotel room in 1958 - about $18-22 a day. Now, the motel/hotel room is $75-100 a day and the hospital room $500-600 a day. That is just for the space, not for an extras like supplies or medications. A room in a motel has quadrupled, but the hospital room has increased by a factor of 25! Hospital staff, such as housekeeping and engineering, etc., don't have salaries that are 25 times higher. I know the factors are many and complex and not as simple as described above, but it is eye opening.

Physicians, on average and adjusted for inflation, earn LESS now than they did in the 50's and 60's. Most hospital staff do also.

What has happened to cause medical care and health insurance costs to skyrocket? Could it be that transforming medical care into a for-profit business has caused it? You bet. Corporate CEOs and stockholders want to see $$$$ in their portfolios.

[Bread and Circus]

21. earn LESS now than they did in the 50's and 60's

damn. No wonder I feel like I struggle and I'm in debt to my ears and the second coming of JC!

[spotbird]

29. How much do radiologists, neurologists

and other specialists net in a given year? Many doctors chose medicine to do good, many others chose the profession to do well. None of them are starving.

[CountAllVotes]

39. they make several hundred thousand dollars a year at least

and you and I both know it - probably 1/2 million a year minimum would be a low estimate. :thumbsup: to your posts. They speak THE TRUTH.

[yorkiemommie1]

23. this makes me sick

our dr. is so conscientious and the medical group is working the staff harder and harder.

[CountAllVotes]

25. you are lucky that they work for you

and not against you.

Ever been billed for 3 visits in the same day by the same doctor being they just don't get enough money for their "visits"? That is what is going on here and it sucks like hell and I have turned them ALL in because they deserve to be turned in! They are crooks in my case.

Consider yourself fortunate.

[yorkiemommie1]

35. i do

yes, i do consider myself very lucky to have Dr. S. looking after me and my husband.

if i were in your shoes, i would be infuriated. i hope things work out for you

[xchrom]

36. back to the topic at hand --

repukes are pigs -- and that's all there is to it.

[daleo]

40. One of the great things about the Canadian medicare system

Is that it takes away the adversarial sense that can exist between doctor and patient due to financial interests, for the most part. You don't hear much of this "doctors are greedy" stuff in Canada, except in relation to the relatively small percentage of doctors who work to undermine the public system. In my opinion those doctors are also undermining their own interests - some have starry eyed notions of how medicine works in the U.S.

DU is a great source for us Canadians who want to defend universal medical care, since we hear so many stories of how awful the alternative can be.

[spotbird]

41. Bingo.

Doctors severely judge those they must treat for less than a premium. Hell, they judge everyone but they tolerate those with the means to pay them less harshly.

[Psephos]

42. It sounds like you're no stranger to judgment yourself

Just a thought....

Peace

[spotbird]

43. You betya.

That makes me human. Someone let the physicians know they are also.