An ongoing survey of practicing physicians on Sermo has revealed important data on the implications of the proposed Medicare cuts on patients and medical practices. Over 1100 physicians have so far responded in to the survey. Here are the highlights:
90% of physicians say that the proposed decrease in physician reimbursement on all Medicare cases would negatively impact their ability to accept new Medicare patients.
63% of physicians indicate cuts would require they reserve less time in their schedules for Medicare patients, while 70% would have to consider switching to a cash-only practice.
88% of physicians say financial pressures would impact their ability to care for patients. They also describe the need to increase patient volume and spend less time with patients to offset payment cuts.
20% concluded they would need to lay off office staff who provide services to their patients.
Over 60% of physicians surveyed said they would have to consider changing careers as a result of the increasing financial pressures to provide medical care.
99% of physicians responding to the Sermo physician survey agreed that the general public does not understand the bureaucratic and financial struggles physicians face in providing healthcare in the United States.
85% of physicians believe that these cuts will make it prohibitive for physicians to accept medicare patients and thus affect patient access to physician care, whether that be specialty or primary care.
Respect for individual liberty is the basis of an ethical society and should be the prominent feature of the ideal healthcare system. The main problem with our healthcare system today is that both doctors and patients have lost their freedom of choice. Third party control of healthcare financing with their cartel-like price fixing behavior and tight grip on the allocation of resources is anti-competitive and dictatorial. The freest nation on earth can and should do a lot better.
The game studio Virtual Heroes and the Department of Homeland Security have come together in making a new video game called Zero Hour: America’s Medic, which allows players to respond to terrorist attacks and diagnose and treat patients. Zero hour can be used for training first responders or just for fun.
If your dog gets sick and need a bronchoscopy, you would have to shell out about $2500 for the procedure, according a couple of veterinary price lists that I found online. The same procedure done in a human is reimbursed by Medicare $156.29 to $377.45 (for a CPT code of 31622 in New York City).
Yesterday, the U.S. House of Representatives passed legislation, on a 355 to 59 vote, to postpone a July 1st 10.6% cut in payments to physicians treating Medicare patients. They instead recommended trimming the government’s funding of the wasteful Medicare Advantage programs, a proposition that the White House has threatened to veto.
The Medicare cuts can seriously threaten the viability of many medical practices and may force doctors to stop seeing Medicare patients. The current postponement under the House legislation is only for 18 months and the ball has moved to the Senate’s court. Powerful health insurance companies are aggressively opposing the House’s decision since it recommends reducing the scope of Medicare Advantage programs. Humana has the most to loose since Medicare Advantage accounts for 48% of its revenues. Patients and doctors, on the other hand, have a lot to gain if the government eliminates these programs.
There is nothing wrong with making money unless it’s at the expense of retarding innovation, competition, and delivery of apporpriate services, as it’s the case with our health insurance system which is operating according to principles set forth by the mafia and third world dictatorships (I’ll write more about this befitting analogy later).
So here’s the latest news from California: “HMOs spent $6 billion on administrative costs, which include hefty CEO salaries, according to a report by the California Medical Association, which said the money could have gone toward driving down premiums or better protecting the insured.”
It seems like people are going bankrupt because of “rising insurance premiums and having their benefits gutted simultaneously.” Insurance companies are even going as far as “taking steps to persuade physicians and patients to switch from effective medicines to different medicines based primarily on cost to the insurer, without appropriate regard for each patient’s best treatment option,” according to an op-ed piece by Marcy Zwelling-Aamot, an internist and critical care physician in Los Alamitos.
I wonder when all this nonsense and criminal-like behavior on part of some insurance comapnies is going to stop.
I’m in Canada again for a business meeting and this was on the front page of Yahoo: “Canadians continue to suffer from a doctor shortage, according to a new report that found 1 in 5 people have not been able to find a physician to treat them regularly.”
There is a serious problem with access to care in Canada, proving that universal coverage does not equal universal access to care. It seems like no one in the country wants to go to medical school anymore, despite the fact that it’s almost free. The draconian healthcare system in Canada is turning a lot of smart people away from pursuing a career in medicine, a trend that is also happening in the U.S., although for different reasons.
The health insurance industry in the United States is the primary reason behind rising healthcare costs and the increasing disenchantment of physicians and patients with the status quo. By inserting themselves between doctors and patients, health insurance companies restrict access to care and divert massive amounts of healthcare dollars into corporate profits. The above graph tells a great story and doesn’t need a lot of explanation. It compares the profits of the top 5 health insurance companies to the top 5 companies in the oil and gas equipment sector who have a very bad reputation in the public eye. Health insurance companies have much better profit margins. It’s important to note that the graph depicts pure profits. Total revenues are much higher. For example, in 2006 UnitedHealth Group had a revenue of $71,542 million and “the evil” Halliburton had a revenue of $22,576 million. This is the money health insurance companies are taking from patients and withholding from doctors, getting in the way of delivering proper care in the process. It’s no surprise that the technical term used by insurers for payments given to doctors is medical loss.
The American Medical Association (AMA), which has been lately criticized by many physicians for no longer genuinely representing their interests, may be finally showing signs of change. In an attempt to “reduce the substantial administrative burden of ensuring accurate insurance payments for physician services” and to counteract health insurers’ biased practice of rating physicians, the AMA has announced the Cure for Claims Campaign, releasing its first health insurance report card. The country’s most profitable health insurance company, UnitedHealth Group, had the lowest rating in the AMA report, paying only 62% of the claims at the contracted rate (i.e., the negotiated rate promised to physicians).
Stating that physicians spend about 14% of their total income to obtain accurate payment for their services, the AMA says that “if physicians and payers use electronic transactions instead of manual ones for the estimated 3 billion claims submitted annually, the health care system can save over $90 billion each year.” This may be true but wouldn’t it better to just take the greedy hands of third parties completely out of our routine healthcare transactions?
The Open Letter Campaign is entering a new phase with top health policy experts and notable figures expressing their support for the movement. One of the latest supporters of the Open Letter is the world-renowned surgeon Dr. Edward R. Annis whose impressive accomplishments include serving concurrently as President of the American Medical Association and the World Medical Association from 1963-1964.
The following is Dr. Annis’s statement about the Open Letter:
I started medical practice in 1938 and for the first twenty years after that patients were free to choose their doctors, to agree with their doctors on what was best indicated to take care of any medical problems that required treatment, and to agree to fair and sensible payment for services rendered. For those with low income or no income, realistic adjustments were common practices so that proper treatment could always be provided.
I consider the Open Letter to be a superb document containing easily substantiated facts as to why people have been separated from their doctors and why todays medical costs are so abusive and unjustified.
The answers are in the first paragraph of the Open Letter which summarizes how patients have been separated from their doctors by politics, profits and special interests.
I consider the Open Letter to be an excellent document containing clear and understandable messages that need no additions and I hope that it gets Nationwide distribution to alert the American people.
Ed
Click here to read the Open Letter from America’s Physicians.
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