Uncertainty over Medicare pay sets doctors on edge

[The Northerner]

WASHINGTON (AP) - For the third time this year, Congress is scrambling to stave off a hefty pay cut to doctors treating Medicare patients - even as the Obama administration mails out a glossy brochure to reassure seniors the health care program is on solid ground.

The 21.3 percent cut will take effect June 1 unless Congress intervenes in the next few days. Recurring uncertainty over Medicare fees is making doctors take a hard look at their participation in a program considered a bedrock of middle-class retirement security.

If the problem is allowed to fester, it could undermine key goals of President Barack Obama's health care overhaul, which envisions using Medicare to test ideas for improving the quality of care for all Americans. Doubts about Medicare's stability can also create political problems for Democrats in the fall elections, since polls show seniors are worried about the impact of the remake on their own care.

"We will not have that cut," House Speaker Nancy Pelosi, D-Calif., vowed Wednesday.

How lawmakers will resolve the problem is unclear. Initially, Democrats had talked about a five-year fix, then three years. Now leaders are proposing postponement through the end of 2011. Doing away with the cuts altogether would be expensive, an estimated $200 billion or more over 10 years. That's what the American Medical Association wants.

"In the past two years, (lawmakers) keep coming up to the deadline - or a little past it - and waiving the cuts for shorter and shorter periods of time, which makes us uneasy," said Dr. Susan Crittenden, a primary care physician practicing near Raleigh, N.C.

Read more: http://apnews.myway.com/article/20100527/D9FV4HHO0.html

[SoCalNative]

1. Simple solution

if you're a Dr. who benefited from any type of federal student aid or loans to go to medical school, agree to accept medicare/medicaid at whatever reimbursement rate the government sets.

If you can pay your own way or get private loans only, then you can do whatever you wish.

That goes for medical corporations as well that take any type of government handout, from tax breaks on up.

[ProgressiveProfessor]

7. Can really do that retroactively...more over is it fair to any business to mandate taking a loss

which is the basis of the uncertainty

[WinkyDink]

2. I never met a poor doctor. And though I think most deserve all they get, they can "do" with less.

[Frances]

3. You are obviously not on medicare

The payments are so low that many doctors won't accept medicare patients. I used to have to drive a long way to find one who would take me. AFter you get on medicare, you can look at the payments and see for yourself that they are too low for someone who has to buy equipment and pay rent for the office.

[alc]

4. poor doctors exist, especially general practitioner & family practice

I know one who owns his own family practice who has only paid himself 3 months in the last 2 years (and his salary is less than mine when he does pay himself). He lives off his spouse's income and says he'd rather not take his pay than lay off his employees or significantly increase his patient load (and give them less individual attention) but he's recently hired a consultant to figure out what other options there are.

I know another one making under $100k/year with over $200k loans. I do know about 10 making tons of money but there are some who don't.

[vicdoc]

5. Hello, nice to meet you....

As a Doctor who went out of business 5 years ago, partly due to poor re-reimbursement with Medicare, you are wrong. The average doctor makes good money, but those in smaller communities, or with large volume practices, have a high overhead.
The average is 50% overhead for expenses: rent, payroll (typically a receptionist, an office manager, and a nurse or 2), insurance and malpractice insurance, the electric and phone bills, transcription, computer billing costs, etc etc.. If Medicare cuts re-reimbursement by 20% the Doctor doesn't lose 20% of his income, he loses 40% of his income. The average family practice doctor earns about $150k a year. this means if he sees a lot of medicare patients he loses about $60k a year if Medicare cuts by 20%. Your average NJ teacher earns about $80k, the average Certified Nurse anesthetist earns what the average family practice doctor as it is. The average doctor went to 4 years of med school, and had a 3 to 5 year residency. He deserves what he earns considering the value of what he does. He makes life affecting decisions every day and risks everything he owns.
What Medicare cuts will do is cause these doctors to see fewer Medicare patients and fill their already busted schedules with standard insurance patients. Older people then find access more difficult, harder to find a doctor, and they go to the ER more often in sicker condition.
The problem is Medicare is tax based, and Medicare patients get $8000 worth of care a year they pay about $1200 for. Nobody wants to pay more taxes, nobody wants to pay more premiums. Everybody wants something for nothing. But everybody wants everything done to save grandma and grandpa, no matter what the cost.
Medicare has crappy re-reimbursement as it is. So 80% of crap becomes, more like crap! Personally, I don't think the cuts will happen. But I don't really give a hoot anymore. They have already destroyed the system, and in less than 7 years the thing goes belly up anyway.
I used to do 90% reconstructive surgery in my mid-sized city plastic and reconstructive surgery practice, much of that was with elderly Medicare folks or young Medicaid patients I enjoyed serving. I now do 100% cosmetic surgery and zero reconstruction due to the horrible re-reimbursement. Where Medicare leads, the private insurance companies follow.

[inna]

6. Weakening, phasing out and eventually dismantling Medicare is the objective here.

It has been a conservative dream for a long, long time. Same refers to another "entitlement", Social Security. :shrug:

[Catshrink]

8. The same thing is happening in education