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Texas Drs opting out of Medicare
Old 05-19-2010, 03:36 PM   #1
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Texas Drs opting out of Medicare

"Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.

Two years after a survey found nearly half of Texas doctors weren't taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.

“This new data shows the Medicare system is beginning to implode,” said Dr. Susan Bailey, president of the Texas Medical Association. “If Congress doesn't fix Medicare soon, there'll be more and more doctors dropping out and Congress' promise to provide medical care to seniors will be broken.”

Texas doctors fleeing Medicare in droves | Houston & Texas News | Chron.com - Houston Chronicle

New wave of the future? There are things that can and will be done to help this situation but they won't be popular, like more means testing, and will take a long while for the culture to accept, like reducing the extent of end of life intervention care.
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Old 05-19-2010, 03:41 PM   #2
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One problem Medicare already introduces is cost-shifting. Medicare's reimbursement rates tend to be quite low, which forces providers to make up for it by charging others more. (This is similar to U.S. prescription drug prices subsidizing the rest of the world that caps what they will pay.) So those of us with insurance other than Medicare wind up paying more and more to make up for what Medicare won't pay -- assuming the provider still takes Medicare patients. And our insurance goes up a lot more than Medicare premiums.

This, IMO, is something people need to keep in mind when they talk up something like a "Medicare for all" solution -- that can only work if Medicare significantly increases its reimbursement rates, or else I suspect you'd see some providers close their doors (especially physicians who are already FI).

Ideally if we reach a point where everyone is (or is supposed) to be insured (2014?), I'd like to see *no* cost shifting and everyone being charged the same rate by the same provider for the same service.
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Old 05-19-2010, 03:58 PM   #3
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Another possible solution is for a lot of primary care providers and some specialties to band together like HMOs, take salaries and create a working environment that makes sense for them while being Medicare providers.
Also, the premiums for malpractice insurance need to go down somehow, I suppose by limiting malpractice suits.

Boy, do I dislike thinking about what all this means for our future health care as geezers and geezerettes. I suppose our life expectances might go though the way-back machine to the 1970s.
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Old 05-19-2010, 04:01 PM   #4
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Quote:
Originally Posted by Oldbabe View Post
Also, the premiums for malpractice insurance need to go down somehow, I suppose by limiting malpractice suits.
Malpractice insurance costs are a concern, but the real problem with all the litigation is the amount of (probably unnecessary) "defensive medicine" that is ordered in order to provide legal CYA for the provider.

You may be 99.9% sure you can diagnose something with a simple and cheap X-ray, for example, but you fear that 0.1% chance that you are wrong and will be sued silly for a misdiagnosis, so you order a costly MRI just to make absolutely sure. This sort of defensive medicine likely costs the system a LOT more money than the malpractice insurance and legal judgments to plaintiffs combined.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

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Old 05-19-2010, 04:03 PM   #5
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Hmm... Texas, specifically?

I wonder if there is an above average number dropping Medicare in the McAllen area? They used to do so well with Medicare...

McAllen, Texas and the high cost of health care : The New Yorker
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