I practiced General and Trauma surgery for 30 years. When I started we charged "Usual, Reasonable, and Customary" charges. We could charge a certain fee, but if it did not comport with those charges that is all we could collect. With Medicaid and Medicare....they set the price. It was nonnegotiable. In the 1980s HCFA lowered the patents based upon DRGs...Diagnosis Related Groups....(non negotiable). They did change the payment schedules in the '90's....they lowered remuneration. Medicaid fees were also lowered in terms of actual dollars....(not adjusted to inflation). As a response to Drs. accepting a certain for, say a cholecystectomy, the dollar cost averaging was swept aside and they (insurance companies) set our fees. OSHA compliance cost more. Drugs cost more, law suits cost more in insurance fees. Now comes OBAMA care. In many cases it cost more in running an office than was generated by an average practice. Therefore, people are not participating as providers. This is what obama wanted......it will lead to a single payer system. This will be horrible for patients. It will be horrible for providers. The Republicans need to realize this and stop screwing with socialized medicine. They will probably fail at this, which will lead to the single payor.
Back in the '90s when things were better physicians, in order to keep staff privileges at a hospital had to 'cover' the emergency room in their specialty. No one liked it, but we did it. From the ER I had a 20% collection rate. In other words I worked one day for myself and 4 days for no pay. We do not ask teachers, or engineers, or accountants or any other groups to do this. I still had to pay office staff for all 5 working days. Then when I had to cover I had to work the weekends. We did not mind this so much....we made a living. That concept is rapidly fading.
Thanks for your story.
No other industry in the US has been worked over like medicine.
I think the Progressives saw Obamacare as a midway step toward total takeover, Canada or UK style.
Back in my high school days—the mid 60s, our family doctor had a large sign painted and hung in his waiting room, blasting government meddling in health care.
I recall it said something like “I am not a government doctor. I don’t work for the government. I work for my patients.”