Posted on 08/05/2014 10:03:10 AM PDT by george76
On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. Gerard, an internist, checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way.
For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates.
That's not something he's willing to accept.
"I cannot accept a plan [in which] potentially commercial-type reimbursement rates were now going to be reimbursed at Medicare rates,” Gerard says. “You have to maintain a certain mix in private practice between the low reimbursers and the high reimbursers to be able to keep the lights on."
(Excerpt) Read more at thefiscaltimes.com ...
Unexpected.
But, but, but he is a rich doctor. He is just being greedy! //sarcasm
My high school friend is my internist. He had add two people to his staff to deal with the additional paperwork. He stopped taking Medicare years ago because the compliance would have meant more staff, for 60% of the revenues.
It doesn’t take a brain surgeon to figure this out.
The doctors will all be Government doctors...hence, death will come on command.
I wouldn’t be surprised to see U.S. doctors establish clinics in The Bahamas, Panama, Costa Rica, Bermude, and at various locations throughout the Caribbean.
Sigh, “Bermude” should be Bermuda.
That’s what happened in Brazil.
When we were there, we could use the government doctors, or we could use the private practitioners.
We used the private practitioners.
I believe it is already occurring, just as the best British and then Canadian doctors established clinics and hospitals in India and Thailand and now Burma.
Soon to be dubbed by the liberal elites as “healthcare inequality”
Look at the increase in things like nurse practitioners and “little clinics” in grocery stores and pharmacies.
Which are fine for things like strep tests, writing antibiotic prescripts for ear infections, doling out flu shots and the like. But not so much for correctly diagnosing more serious ailments that happen to have similar symptoms to the common cold.
The doctors along with almost everyone else in the health care field will also be dues paying union members.
I Canada it took about 14 years to get to a one payer system. The Canada Health Act enslaved the doctors!
The entire system will be the VA, and we know how well that is going
I see hospital ships, just outside the maritime zone limit. It would be like gambling barges or cruises. Of course, laws would have to change a bit with respect to liability, but that would come.
On the land-based clinic side, I've been talking with a friend who has knowledge of doings in the Caymans. In one of the remote arms of Grand Cayman, a hospital has been build to focus on cardiac care which is primarily staffed by Indian doctors. Supposedly it's a well-run place, but hasn't established enough of a track record of care to do business with American insurers. Sign of the times...
I see “border clinics” on the Mexican side of the border!
Already happening........
As a doc, the bigger concern is that it enslaves patients. Physicians in the UK can make boatloads of money, paying their NHS dues seeing patients in the am, and seeing private patients either earlier or later in the day. I think that's a horrible system, but when you hear what physicians are paid over there, it's likely that you are hearing their NHS salaries - not counting their supplemental income from seeing private patients. If you don't have the money to go private, you sit on the waiting lists.
What's happening here in the US is that patient choices are getting smaller and smaller. One contribution to this is that big hospital systems buy out the smaller hospitals and buying out the private physicians - creating a huge ‘mega-store’ type of health care structure. Competition is a great determinant of quality. The type of competition that now exists is the competition to most efficiently and cheaply check off the boxes on the ‘quality assurance’ check list.
Contrary to the assurances and beliefs of the quality assurance ‘outcomes analysis’ advocates, this does not lead to high quality care. it leads to ‘average’ care, with a fair amount of things that slip through the cracks that won't be seen by the kind of statistical analysis that is done. Think of it this way, ‘Dr. House’ would never be tolerated in this kind of system.
This is not to say that all or even most hospital administrators have this mentality, but it's the nature of the system, and it is very sad.
I just received notice from my Medicare Supplement insurance that my orthopedic doctor will no longer be included in my coverage. Either I have to find a new doctor, or I have to find a new supplement for my other knee, or any other ailments I develop.
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