Friday, April 17, 2009

MDs Opting Out: Health Insurance ≠ Health Care

Here's something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn't automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especially government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have.

Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients. The statistics are similar in New York state, where I practice medicine.

More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I've had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider -- who they liked -- abruptly stopped taking Medicare.

~"When Doctors Opt Out" by Marc Siegel, MD, in today's WSJ

11 Comments:

At 4/17/2009 1:03 PM, Blogger misterjosh said...

I find Mr. Siegel's naivete disappointing. If/when they do "universal health care" then they will make it illegal for doctors to NOT accept "insurance."

 
At 4/17/2009 1:04 PM, Blogger Colin said...

Can't wait until the government takes over the entire health care industry. I'm sure it will lead to new efficiencies and heights in customer satisfaction.

 
At 4/17/2009 2:10 PM, Blogger Unknown said...

So Misterjosh, you are telling me that by force of the government (fines, jail even the death penalty), you are going to force a doctor to perform a service for which he does not get adequate compensation. Sounds like a great system to me, perhaps you can get my auto mechanic to sign up for the same government program.

 
At 4/17/2009 2:56 PM, Blogger Free2Choose said...

"Sounds like a great system to me, perhaps you can get my auto mechanic to sign up for the same government program."

Perhaps, comrade, both your mechanic and your family physician are in need of some time in the State "re-education program". Then they will understand their need to "volunteer" their services for the betterment of our Great Society.

 
At 4/17/2009 3:21 PM, Blogger bobble said...

no problemo. this is already being solved by admitting hoards of foreign doctors on skilled work visas. as the visa floodgates open wider, there will be plenty of doctors at low prices.

of course, no americans will bother to study medicine anymore. but thats just collateral damage on our race to the bottom of the wage scale.

 
At 4/17/2009 10:47 PM, Anonymous Superheater said...

When doctors have no alternative but government "insurance" they will put down their stethoscopes and become engineers on all these high-speed rail lines Obama wants to make you ride. State Control is FREEDOM!!!

 
At 4/17/2009 11:25 PM, Blogger DaveinHackensack said...

"So Misterjosh, you are telling me that by force of the government (fines, jail even the death penalty), you are going to force a doctor to perform a service for which he does not get adequate compensation."I doubt jail or the death penalty would be necessary to get most MDs in line. Instead, the government could offer a universal health insurance plan of its own, and deliberately undercut the prices of private health insurers. Once the government has driven the competition from the market, it will be able to get more aggressive in setting lower reimbursements for physicians.

Physicians will then have the choice of accepting those lower reimbursements, or limiting their practices to patients paying out of pocket. A handful of physicians might make a good living with boutique practices treating the wealthy, but most docs will end up taking a pay cut either way: either they accept the government insurance plan's lower reimbursements or they settle for what average Americans can pay out of pocket. It's no secret that physicians in first world countries with fully socialized medicine make a lot less than ours do here.

I happen to be against a single-payer health care system, but Dr. Siegel isn't making the best case against it.

 
At 4/18/2009 7:48 AM, Blogger Webutante said...

Perhaps doctors who opt out will work at Minute Clinics and/or start underground health care facilities for cash or barter. Inventive people will find ways to circumvent the government run system, if necessary. But let's hope it never gets to that.

 
At 4/21/2009 1:29 PM, Anonymous Physician disability insurance said...

It would be nice to have universal health care, but physicians go through years of training and I think they should be compensated for their specialized work.

 
At 4/21/2009 2:21 PM, Anonymous Anonymous said...

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At 4/25/2009 1:59 AM, Anonymous Anonymous said...

I am a medical doctor and I would rather go to jail then capiitulate to become a slave. Any patient who expects me to be their property better not come to me for care.

The truth is that the secret to patient care is caring about the patient. This will end under forced labor. Be careful about what you demand , you might have to deal with it.

 

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