Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
The fact of the matter is the medical/insurance industry should have gotten their **** together long ago. If they had, there would be no "evil regulations".
My Mom had a seizure and spent two days in the local hospital. The total charge was $30,000+, including half a dozen doctors who were "consulted," 3 MRI's and a $2500 ambulance ride from the rest home to the hospital (Total miles one way...3). Every penny of it was paid by Medicare.
I'd suggest that if a reduction in Medicare payments is causing doctors to go "broke," maybe they ought to wean themselves off raping the taxpayers and learn to live with a reasonable fee.
Wrong...you need to check the EOB on that.
I guarantee you Medicare did not pay every penny.
My guess would be 20% - 30% at the most.
Wrong...you need to check the EOB on that.
I guarantee you Medicare did not pay every penny.
My guess would be 20% - 30% at the most.
You have to laugh at people who think that Medicare pays "billed" charges vs. "allowed" charges and then states that Medicare pays 100% when the patient is responsible for the deductible and 20%.
Last edited by pommysmommy; 01-06-2012 at 06:37 PM..
The average doctor in this country makes over $300,000 per year. If a 25% drop in what Medicare is giving them is what's causing them to go broke, they should re-evaluate their business model.
I am a physician. This is what the public does not understand, and I will try to illustrate it for you as clearly as I can.
A medical practice has very high overhead. When one cuts reimbursement, the overhead is fixed. Therefore, depending on levels of overhead, a 25% cut in reimbursement may cut salaries in half.
Depending on your specialty, you may have many or few partners and may have a very high, or relatively low, overhead. For example, I have a $700K per year overhead (I must generate $700K in payments, not charges, to break even). Most of the internists in our group practice make $230K per year and have $130K per year overhead. Depending on how many physicians you have in your "pod" and your relative reimbursement, things can change rather quickly.
Our cardiologists, which five years ago were $800K per year physicians, are now making $275K per year for the same level of work. They have been wiped out my medicare changes and there is more to come, such that they may generate personal revenues for the clinic close to zero. We will have to make a decision as to whether to support thier salaries or to dump that speciality, as even the hospitals cannot make money off of them. Obviously, medicine needs cardiologists in one form or another.
This "squeeze" is always what I envisioned- an incremental decline in reimbursement that would force private physicians to become employees of the state to remain solvent. It is inevitable, given the gradual decline in reimbursement. Our group is in a powerful position, however, in that we have more money than the hospitals and are seeking to buy one or the other of the local hospitals. In that regard, we will do well financially and will control medicine in a fairly large metro area such that we cannot be eliminated. Most physicians do not have that luxury.
It will be an interesting next ten years. I still fully encourage those interested in medicine to pursue such a career, as it is interesting and certainly engaging for those interested in "puzzles" and science. For those interested in money, other endeavors are probably better.
I will soon be more on the recieving, rather than provider, end of medical care in a few years. Given the product I am seeing coming out of med schools and their motivation, God help us all. They aren't what they used to be.
If you are free market advocate and doctors are free to deny treatment to medicare patients then how is the government forcing doctors out of business?
Now if you aren't a free market advocate, then you must be in favor of some government subsidy/socialism in the medical industry, as a result the only argument that we are having is who's version of socialized medicine one advocates.
If we can get an agreement on the latter point, then we have the possibility of a honest discussion, otherwise the complaint is pure political BS.
Pardon the expression but you are speaking out of your anal sphincter. According to the Government Accountability Office the national average, as of 2009, was $4,000 per year for internal medicine; $10,000 per year for general surgeons; and $17,000 per year for OB/GYN's.
Pardon the expression but you're totally cluless. And, obviously, so is the GAO. Where they come up with those figures...I have no clue.
What I do know is that there is NO physician in private practice paying that little. I know because I run multiple-specialty practices around the country and I pay those premiums. The rates are about 3x those amounts.
My guess is those averages are based on total premiums paid (which are paid by less than 100% of total physicians in the country) divided by the total number of physicians in the country (including those who have sovereign immunity - don't have to carry insurance or carry very small coverage amounts - due to working for a government entity (e.g. VA, military, political subdivision of a state, etc)).
Leave it to the Gov't to publish misleading "statistics".
I am a physician. This is what the public does not understand, and I will try to illustrate it for you as clearly as I can.
With seven physicians in my immediate family, I do appreciate your remarks, but my question still holds. If you are an advocate of free market economics then government reimbursements are so necessary for x amount of doctors remaining in their practice then it should be readily apparent that those government payments maintain and artificial supply of physicians. That being the case then the reduction in government reimbursements isn't the problem based upon free market economic principles.
Do I favor purely free market principles in the medical field? No. But as I've stated before, if we accept that purely free market principles do not allow for the best distribution of healthcare goods and services then some form of "socialized" medical is vital. But only when we admit that can we have a serious conversation on how should be implemented.
I am absolutely open to looking at AHCA over time and observing what works and what does not, but the conservative push to simply repeal the act without any serious discussion about either a replacement or at the very least some amendment, the conversation is a non-starter.
If you are free market advocate and doctors are free to deny treatment to medicare patients then how is the government forcing doctors out of business?
In some locations, like in Hawaii where I live, some payer fee schedules are tied directly to the medicare fee schedule. It's Hawaii law. Specifically, anyone with an open no-fault (auto accident) or work comp claim, the fees paid on services rendered to them is based directly on the Medicare fee schedule. Any physician who has built their practice treating a lot of people with injuries from auto or industrial accidents would get hammered if the Medicare reimbursements dropped by 27%
If you are free market advocate and doctors are free to deny treatment to medicare patients then how is the government forcing doctors out of business?
Now if you aren't a free market advocate, then you must be in favor of some government subsidy/socialism in the medical industry, as a result the only argument that we are having is who's version of socialized medicine one advocates.
If we can get an agreement on the latter point, then we have the possibility of a honest discussion, otherwise the complaint is pure political BS.
1. One has the ethical decision as to whether to deny medicare patients or not. We lose money on every medicare patient, however, my parents are on medicare, as are most every else's parents. Denying them access creates a "cascade" in which one practice denying access encourages everyone else to eliminate access. We have seen this with "Tricare" (which is the military insurance- I am the only provider in our community who still accepts tricare, but I have to limit access to avoid insolvency, as others have abrogated what I consider to be thier ethical obligation). Believe it or not, we are not all (and most are not) in it for the money. Denying ALL medicare access would make the best buisness sense, but it is not in the best interest of the public. One struggles with these issues.
2. If one was left with pure "capitalism", all of us in medicine would be fine. We would deny all the medicaid, medicare, and no insurance patients on call. However, that is not practical from a society standpoint and one cannot simply stand there and do nothing (or not drag your ass out of bed) just because you are not going to get paid. That is certainly not the first thought that goes through your head. In fact, we only find out months later whether we actually got paid for ANYTHING we did.
3. I am in favor of elimination of all public forms of medical support and allowing the free market to determine salaries, overhead, level of care, and hospital reimbursement. I think that medicare (which was good when it started) has created a "crack *****" atmosphere in medicine in which facilities and physicians are "addicted" to a "bad drug" at this time. The markets will determine what is appropriate and what consumers need in the future. This, I am sure, will come in the form of very high deductible plans for insurances which make provisions for only catastrophic medical problems.
Again, at this phase in my life, I am looking at this more from a consumer than a provider standpoint.
In some locations, like in Hawaii where I live, some payer fee schedules are tied directly to the medicare fee schedule. It's Hawaii law. Specifically, anyone with an open no-fault (auto accident) or work comp claim, the fees paid on services rendered to them is based directly on the Medicare fee schedule. Any physician who has built their practice treating a lot of people with injuries from auto or industrial accidents would get hammered if the Medicare reimbursements dropped by 27%
Kaimuki, the majority of insurance payers base their reimbursement on the medicare fee schedule across the United States.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
