Let’s kill the big lie!

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OK, I need to inject a little politics into the blog today.  I try not to do so.   But, there is no way to discuss this matter without injecting politics into the discussion.

I find it offensive when a certain political party invents facts.  I find it amazing how no one questions that big lie, either.  Well, it’s time to burst one really big bubble. The lie:  Private practice doctors hate Medicare so much they all want to limit their practice to non-Medicare patients.

Fact: It is absolutely true that Medicare reimburses medical care at lower levels than does private insurance.  (Why do you think insurers like CareFirst [BlueCross/BlueShield of the DC area] refuse to be primary insurers, if an employee is over 65?  They get to use Medicare’s rates that way and then pay less- way less- to the doctors for that care.) But (another fact), data shows that Medicare pays more regularly and with less rigmarole than private insurance.  (Many physicians require outside assistance to collect funds from private insurance.)

And, now, Drs. Bishop, Federman, and Keyhani (these physicians also earned Masters in Public Health [MPH]) just published a study (Archives of Internal Medicine) describing the drop from 95.5 to 92.9% in physicians’ acceptance of new Medicare patients between 2005 and 2008.  A drop, you say?  See, Roy, it wasn’t a lie after all…

Well, hold on there, partner- the drop of physicians taking private insurance was even greater!  Those numbers fell from 93.3% to 87.8%.   And, note carefully that the absolute numbers (95.5 v. 93.3; 92.9 v. 87.8) are lower for private insurance, as well as the greater drop in acceptance rates over the 3 year period (2.6 v 5.5).  This phenomenon is the result of the administrative hassles and impediments imposed upon the physicians by the private insurers.  While Medicare pays lower rates, they do pay at a more reliable frequency (private insurance rejects more claims on first pass than does Medicare).

I previously reported on 28 January 2011 that most physicians incur multitudes of uncompensated efforts each day– hours on the phone, writing and responding to eMails, conferences with other physicians trying to solve their patients’ problems- for which no  one ever compensates them. Couple the administrative hassles, the reimbursement snafus, and the uncompensated care and it is perfectly clear that patients are going to find it harder and harder to get doctors to treat them.  Recognize further that the population is aging- Medicare enrollment will rise from 47 million (2010) to 80 million (2030), with a higher percentage of folks at the ends of their lives (80+ y of age)- and the problem of obtaining coverage is approaching a crisis stage.

Consider that the next time you hear of the “improvements” being offered- vouchers to buy private insurance (without increasing that payment for years).  This means patients will either have to shell out more money to buy that insurance or go uncovered because they can’t afford the insurance.  And, this all assumes that physicians will deign to accept those policies as payment.  (And, when they don’t- that’s even more money patients will have to spend for health coverage.)  Roy A. Ackerman, Ph.D., E.A.

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5 thoughts on “Let’s kill the big lie!”

  1. Great analysis, Roy! I love when you turn so-called facts on their head and reveal the truth! Clean reasoning and thanks for taking the time to explain this!

    1. Samantha-
      To some degree, my religious upbringing required us to examine each text to determine it’s meaning and it’s background. That training started when I was 5! And, I am definitely a “child of the 60s”. Our mantra was “question everything”.
      I, like everyone else, would LOVE a simple answer that can be used. We have a problem with deficits- let’s stop spending everything. Of course, that would work- but leave everyone at risk, and not address the needs of a nation.
      We need to examine each question- first, to see if that really IS the question… (Too many of us confuse causation with correlation…) Then, we need to define what we are addressing- and what we are omitting. Then, develop a solution. Then, TEST THE SOLUTION (there’s a step rarely effected). Then, modify based upon tests and act! Finally- refine and start the process all over again, because circumstances ALWAYS change. (Hence- question everything!(
      It should be the mantra of entrepreneurs bringing out their new products and services, too!
      Sorry, I made this answer WAY too long (loved the feeling of being atop my soap box, once again.)
      Thanks for your comments…
      Roy

  2. Which reminds me about the instance here in my country where teachers here fight for an item in a public school. Happens that public school teachers have their salary every 6 months while in a private school, they have it every month. But then they choose public school because the government pays more than in private schools.

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