July 13, 2010

A sign of the times - Doctors and Medicare

When push comes to shove, some people are simply removing themselves from the equation. From Dallas, Texas station NBC/DFW:
Doctors Threaten to Pull Out of Texas Medicaid
Cuts to the reimbursements given to doctors who treat patients covered by the state's low-income health care program are raising fears that already declining physician participation will fall even further, according to a published report.

The health care and insurance industries fear that a 1 percent cut in Medicaid fees scheduled to take effect Sept. 1 will be the first in a series of cuts as state agencies are asked to trim their two-year budgets by 10 percent to help cover an expected $18 billion revenue shortfall, The Dallas Morning News reported Sunday.

About 3.3 million poor and disabled Texans depend on Medicaid for health care, but less than a third of the state's 48,700 practicing doctors accept patients covered by the federal program, according to Texas Health and Human Services Commission. And some doctors who do participate in the program limit the number and kind of patients they accept.

The commission, which administers the program in Texas, is among the state agencies that state leaders expect to cut spending. Thomas Suehs, the commission's top executive, said he realizes the bind that physicians find themselves in.

"No one ever wants to cut Medicaid," commission spokeswoman Stephanie Goodman said. But, she noted, "it's 75 percent of our budget. So when you start to identify places to reduce our budget, it gets very hard to skip Medicaid."
Medicare and Medicaid were set up with no real thought being given to the true cost of administration. When confronted with reduced budgets, the bureaucrats cut the Doctors fees instead of the size and scope of the bureaucracy. Something is rotten here... Jen and I were talking about this yesterday -- if we privatized everything, put everything out into the public marketplace, costs would drop as competition set in. Tort Reform would be nice but this infringes on a State's Rights issue which I have zero complaints about. Maybe when a few states enact a strong tort reform to limit malpractice, others will resist the pressure of the trial lawyers and do the same. The third item (if we were King and Queen) would be to set up medical savings accounts. Your employer could also contribute and these earnings would be completely tax free. You would then get a very high-deductible insurance policy -- something in the order of $20K deductible but you would be covered for anything and everything after that. Sure, $20K is a huge hit but that is what your savings account would be for. You could also use the savings account as a regular source of funds but you would be liable for a tax penalty for withdrawal for non-medical uses. The fourth and final item would be to promote the use of small 24/7 medical clinics to take the burden off the Emergency Rooms. In this case, household pets have it better than their owners up here as local vets staff an after-hours clinic that provides good and reasonably priced vet services. I know that both WalMart and Walgreens have opened a number of these and plan to expand. Honestly priced health care could be here if the people in Washington weren't bending over to accommodate their pet interests and building their power base. It really is that simple. Posted by DaveH at July 13, 2010 9:53 PM | TrackBack
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