The market speaks: doctors increasingly turning down new Medicare patients
USA Today brings us a story that should surprise no one. Medicare, the supposed model of a government run health care system, is finding that fewer and fewer doctors are willing to take on new patients under that system. They cite the low payments Medicare offers (or perhaps forces) for patient treatment. Baby boomers just now entering the system are going to find their choice of a doctor restricted.
The numbers break down like this:
• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If the cut is not reversed, it says, the numbers will double.
• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.
Note especially that final group. Primary care physicians are the group of physicians that the newly passed health care reform law depends on to implement its “preventive care” regime.
The reason is rather simple and straight forward – Medicare offers 78% of what private insurance pays in compensation for a doctor’s services. Why doctors are leaving or restricting new Medicare patients is rather easy to understand as well:
“Physicians are saying, ‘I can’t afford to keep losing money,’ ” says Lori Heim, president of the family doctors’ group.
Consequently they cut or drastically restrict the source of the loss. While most doctors are not going to turn away existing Medicare patients, they may not accept new ones and finally, through attrition, close their practice to Medicare patients.
It isn’t rocket science – no good businessman is going to continue to do things in which the net result is a loss of money. And a doctor’s private practice is a business – one which employs a number of people. He or she, like any business person running a small business, cannot afford the losses. So they identify the problem and eliminate it.
As this continues it will put them in a direct confrontation with the federal government. It is anyone’s guess, given the current administration’s choices for wielding power, how that will turn out. But what this rejection of the compensation offered by government is doing is bringing to the fore is one of the underlying conflicts of the new health care law – the premise of the law is that government can control costs (and payments) and thereby make medical care less costly. The doctors are saying, go for it, but I’m not playing.
At some point, government is going to have too address those who make that declaration. We’ll then see how free of a country we really are, won’t we?
~McQ
Is the health care individual mandate a tax?
If so, that’s precisely the opposite of the claim from Obama and the purveyors of health care reform. But it appears that’s what the administration is arguing in court in order to keep the courts from killing the provison:
Late last night, the Obama Department of Justice filed a motion to dismiss the Florida-based lawsuit against the health care law, arguing that the court lacks jurisdiction and that the State of Florida and fellow plaintiffs haven’t presented a claim for which the court can grant relief. To bolster its case, the DOJ cited the Anti-Injunction Act, which restricts courts from interfering with the government’s ability to collect taxes.The Act, according to a DOJ memo supporting the motion to dismiss, says that “no suit for the purpose of restraining the assessment or collection of any tax shall be maintained in any court by any person, whether or not such person is the person against whom such tax was assessed.” The memo goes on to say that it makes no difference whether the disputed payment it is called a “tax” or “penalty,” because either way, it’s “assessed and collected in the same manner” by the Internal Revenue Service.
You may remember the rather testy interview with George Stephanopoulos in which Obama used the dictionary to bolter his argument that the individual mandate wasn’t a tax? And he also said this:
OBAMA: My critics say everything is a tax increase. My critics say that I’m taking over every sector of the economy. You know that. Look, we can have a legitimate debate about whether or not we’re going to have an individual mandate or not, but…STEPHANOPOULOS: But you reject that it’s a tax increase?
OBAMA: I absolutely reject that notion.
Apparently his critics were right. And what should also be evident is this will be one of the largest tax increases the middle class has ever seen.
So much for the 95% no-tax-increase pledge (which went by the boards almost immediately, but this is another example of that broken pledge and another reason to distrust whatever Obama says).
~McQ
You can see this one coming a mile off
The other day in the comment section of one of the many posts on health care, Looker brought up the fact that the new HCR law counts obesity as a chronic illness and uses Body Mass Index (BMI) to determine whether or not one is obese. BMI, of course, is not the greatest way to determine obesity. In fact, given that BMI is used, I even question the underlying definition of “obese”. But that’s an argument for another day. Suffice it to say, obesity is now officially a “disease” or “illness”. And, of course, that means all sorts of new things when talking about it or taking action to counter it, doesn’t it?
So it came as no surprise to me to see this article about the conclusion of a recent study (timing being everything):
The study, involving rats, found that overconsumption of high-calorie food can trigger addiction-like responses in the brain and that high-calorie food can turn rats into compulsive eaters in a laboratory setting, the article said.
[...]
“Obesity may be a form of compulsive eating. Other treatments in development for other forms of compulsion, for example drug addiction, may be very useful for the treatment of obesity,” researcher Paul Kenny of The Scripps Research Institute in Florida said in a telephone interview.
Obesity-related diseases cost the United States an estimated $150 billion each year, according to U.S. federal agencies. An estimated two-thirds of American adults and one-third of children are obese or overweight.
Question – is there anyone out there that hasn’t understood that much of the obesity we see is caused by overeating and overindulging in the wrong types of foods? Anyone? So that’s not news, is it?
So what is the key point to be gleaned from this study?
Well, what does “compulsive” mean? Ah, yes, now you get it. The first sentence leads us into the swamp. Compulsion, as it is used here, is synonymous with addiction. If obesity is a form of addiction that changes the whole game, doesn’t it? It is suddenly something you can’t help. It is something you need help beating, right? And – follow me here – if the medical profession now finds itself with more and more “government insured” patients who are considered “obese”, per the law and obesity is a “chronic illness”, per the law, what’s likely?
For those who still aren’t following this, don’t forget the first lady has declared “war” on childhood obesity, the last sentence above tells us that “obesity-related diseases cost the United States an estimated $150 billion each year”, and the government has promised to reduce health care costs via preventive medicine. So where do you assume that leads us?
Or, here, let me ask this another way that may simplify it for you- which industry is the next to be demonized and which group is next to be draped in the mantle of victimhood and told “it isn’t your fault” while the rest of us pay for their “treatment” ?
~McQ