Impeding changes to our Health Care system

[TheMercenary]

WASHINGTON (AP) - A bipartisan group of senators agreed tentatively Tuesday on a plan to squeeze an additional $35 billion out of Medicare over the next decade and larger sums in the years beyond, according to congressional officials, a step toward fulfilling President Barack Obama's goal of curbing the growth of health care spending.
Under the plan, an independent commission would be empowered to recommend changes in Medicare annually, to take effect automatically unless Congress enacted an alternative. In addition to saving money, the proposal is aimed at turning the program for those age 65 and over into one that more clearly rewards quality, officials said

http://www.breitbart.com/article.php...show_article=1

I wonder what they will do as more doctors choose not to care for these patients because reimbursement rates are already less than required to run a practice. No one can run a practice today on Medicare alone or even with it being a majority of the patients. Could be pretty gloom for a few years for those seniors on medicare.

[Clodfobble]

Originally Posted by TheMercenary

No one can run a practice today on Medicare alone

We have a family friend who is a dentist, and he runs not one but three quite profitable practices on nothing but Medicare patients. In two of his three areas he is in fact the only dentist in the county who will take Medicare, and he laughs at the business opportunity being squandered by the other dentists. It's all about keeping overhead costs low and being willing to do the paperwork.

[xoxoxoBruce]

But wouldn't a dental practice be easier to predict and control costs? There are only so many options in dentistry and if it gets complicated, like a bone infection or something, they'd pass the patient on to an MD or surgeon.

I can see a huge savings potential in streamlining paperwork, although that may make fraud easier. They should put UT in charge of designing a fraud-proof electronic tracking and payment system.

[TheMercenary]

Originally Posted by Clodfobble

We have a family friend who is a dentist, and he runs not one but three quite profitable practices on nothing but Medicare patients. In two of his three areas he is in fact the only dentist in the county who will take Medicare, and he laughs at the business opportunity being squandered by the other dentists. It's all about keeping overhead costs low and being willing to do the paperwork.

He is definately not in the majority as you point out. Most people in the Medical profession, not Dental, could not survive on that.

[Clodfobble]

According to him, it's not that they couldn't, it's that they don't want to. Average salary for a dentist is $250K per year, but a huge percentage of them, especially the younger ones, would rather just work 2 days a week and live on $100K instead. And if they're only working 2 days a week, it's not hard to find enough patients to fill the appointment slots without accepting Medicare.

The hard truth is that people on Medicare are a hassle, not just from a claims perspective but on an individual perspective as well. Poorer people tend to be less educated, less likely to show up for their scheduled appointments, less interested in working to maintain their own health, more likely to have badly-behaved children in the waiting room, etc. That is why doctors don't want to deal with them.

[TheMercenary]

Originally Posted by Clodfobble

The hard truth is that people on Medicare are a hassle, not just from a claims perspective but on an individual perspective as well. Poorer people tend to be less educated, less likely to show up for their scheduled appointments, less interested in working to maintain their own health, more likely to have badly-behaved children in the waiting room, etc. That is why doctors don't want to deal with them.

That may be part of the reason but the biggest reason is because of ever decreasing reimbursements, and that is the biggest reason.

[Shawnee123]

Originally Posted by TheMercenary

That may be part of the reason but the biggest reason is because of ever decreasing reimbursements, and that is the biggest reason.

How do you know? Clod just told you that she talked with family friend who is a dentist, and who illustrated the "biggest reason (times 2, even)" many don't want to deal with medicare.

[TheMercenary]

Originally Posted by Shawnee123

How do you know? Clod just told you that she talked with family friend who is a dentist, and who illustrated the "biggest reason (times 2, even)" many don't want to deal with medicare.

I am not disputing her experience with the one person she had contact with. I fully believe her.

I am talking about the main reason there are so many Docs that do not accept Medicaid, Medicare, Tricare, and a few other state run programs.

[Shawnee123]

*shrugs*

cite

[TheMercenary]

Originally Posted by Shawnee123

*shrugs*

cite

My 30 yrs working in health care. Gimmie a minute and I will pull something out of cyber air.

The primary reason physicians cease to accept new Medicare patients is the rate of payment; secondary reasons include complexity of the Medicare program, intensity of treatment needed for elderly patients, and personal preference.

http://www.unmc.edu/ruprihealth/Pubs/PB2004-5.pdf

"The decline in physicians providing charity care and treating Medicaid patients is a sign of the financial pressures facing physicians," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded exclusively by The Robert Wood Johnson Foundation. "With substantial pressure on payment rates from private insurers, physicians may place a lower priority on treating the uninsured and Medicaid patients."

http://seniorjournal.com/NEWS/Medica...Physicians.htm

http://pn.psychiatryonline.org/cgi/c.../full/37/22/10

http://www.kevinmd.com/blog/2008/12/...to-accept.html

http://www.physicianspractice.com/in...icleID/369.htm

This study shows that the acceptance had stablized during a 10 period but the threat to declining acceptance was still a threat (in the conclusions).

http://www.hschange.com/CONTENT/811/

Potential Impact of Obama Care

http://online.wsj.com/article/SB124208383695408513.html

I could go on but why...

[Shawnee123]

So I just choose whose first-hand account I most believe?

[TheMercenary]

Look again. But hey, we choose who we want to believe everyday. What eva...

Some numbers on here:

http://www.dcmsonline.org/legislativ...mbursement.pdf

https://texmed.org/Template.aspx?id=7431\

http://www.mcclatchydc.com/173/story/43362.html

Waits in care for Medicaid due to lack of physicians accepting the insurance in the Dallas area (2009)

http://www.dallasnews.com/sharedcont...d.4187740.html

[Shawnee123]

I just thought of my choices in the matter: level-headed Clod, or the guy who so hates the Obama administration that anything and everything even remotely related to anything and everything they do is SUSPECT and EVIL and GOING TO KILL US ALL.

Just sayin'

[TheMercenary]

Originally Posted by Shawnee123

I just thought of my choices in the matter: level-headed Clod, or the guy who so hates the Obama administration that anything and everything even remotely related to anything and everything they do is SUSPECT and EVIL and GOING TO KILL US ALL.

Just sayin'

Hmmmmmm... ok, I find it hard to believe that I ever said anything among the likes of "GOING TO KILL US ALL!"

A bit of an overstatement, but hey, like I said, what eva...

[Shawnee123]

I was employing hyperbole, as I often see in your cited articles.

OK, I'll quit now!