Obamacare's Soft Opening
While this is not the first story on the "unintended consequences" of our new national healthcare utopia....it is certainly not the last.
Doctors say Medicare cuts force painful decision about elderly patients
By N.C. AizenmanWashington Post Staff Writer Friday, November 26, 2010; 12:02 AM
Want an appointment with kidney specialist Adam Weinstein of Easton, Md.? If you're a senior covered by Medicare, the wait is eight weeks.
How about a checkup from geriatric specialist Michael Trahos? Expect to see him every six months: The Alexandria-based doctor has been limiting most of his Medicare patients to twice yearly rather than the quarterly checkups he considers ideal for the elderly. Still, at least he'll see you. Top-ranked primary care doctor Linda Yau is one of three physicians with the District's Foxhall Internists group who recently announced they will no longer be accepting Medicare patients.
"It's not easy. But you realize you either do this or you don't stay in business," she said.
Doctors across the country describe similar decisions, complaining that they've been forced to shift away from Medicare toward higher-paying, privately insured or self-paying patients…
Of course, in the future there very well could be no private insurance (remember the left's single-payer dream?), so doctor's would have no choice but to accept the government rate....or get out of the business.
So...fewer doctors, less reimbursement....meaning "painful decisions" for America's patients. It sounds like "death panels" are getting a soft opening, given that Obamacare doesn't really take effect for a couple of years.
Gee...who could have forseen this???
[h/t: Patterico]
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Comments :
Aug '10
Re: Obamacare's Soft Opening
Imagine the world's biggest ball of string.
Now we have find the other end of the string and straighten out the entire strand, get the knots out, tie all the loose ends up, roll it back into a big ball. And throw it away.
This is the gift of Obama, it will cost billions to straighten out, it will be as divisive a process as that of emancipating the slaves, thousands will fall through the holes that were once safely netted by their community, churches and local welfare concerns ( all outlawed in form and purpose) .
This deconstruction is one of the reasons for the Tea Party movement, and it's preliminary success. We have to get to work immediately. The schadenfreude implicit in seeing Obamacare fail better be transitory, because the point is : Can we fix it and make it better than it was before ? How did we let it get so bad that they were able to get away with this ?
There were plenty of warning signs, alot of undue media coverage of exploding health care costs were setting us up for the kill shot, and it worked.
It is going to be Hello Greece or Greatness ?
Jul '10
Re: Obamacare's Soft Opening
This is also why the "Let's fix it" crowd has no credibility. Obamacare is a pernicious screed, causing untold damage on every page with its command and control philosophy. From the people who brought you the IRS and the TSA, newer, bluer, healthcare!!!! But Sisyphus, isn't blue a color to be avoided in health care??? Shh, the Comandante will hear you.
The overwhelming ignorance of thinking the American people would roll over for this just may have overreached a tad.
Nov '10
Re: Obamacare's Soft Opening
In fairness to Obamacare, it only seems to me to have accelerated the trend that I have seen in Medicare over the years I've spent in medicine: they cut costs by cutting reimbursement for services. The overall effect has been that physicians, in order to avoid a decline in income, must do much more of what they do in the same amount of time. It is impossible, under these circumstances, to do the things you do as well as you once did.
Medicare sets its rates and policies and the private insurance companies follow suit. Medicare reimbursement rates are entirely removed from any market effects. Thus the entire practice of medicine is focused on trying to strike a balance between the competing demands of the insurance gods, who must be appeased if a practice is to stay alive, and the patient.
I'm afraid that "the world's biggest ball of string" is not Obamacare by itself; it's our current "system" with Obamacare only a relatively thin tangle on the surface.
Jun '10
Re: Obamacare's Soft Opening
No, Dr Lucy, they ignore "costs" of providing care and attempt to cut expenditures by cutting reimbursement. The costs are not responsive to the changes in reimbursement, as you are not doubt well aware when you pay the overhead of your practice hoping that there is something left for your draw.
Your rational response will be to limit yourself to the number of patients that you can treat each day and still maintain the standard of care. At that point your rational response should be to fill the available slots with the best paying patients and limit the access to your practice to the few Medicare and Medicaid that can be accommodated at the margin. All physicians will do the same and the limited access will drive us the rest of the way to single payer. Then, you will be assigned patients, or turn in your license.
Edited on Nov 29, 2010 at 9:58amJul '10
Re: Obamacare's Soft Opening
When I hear the "Fix It" crowd make their insistances it brings an image to my mind from the old series Get Smart.
Smart was ordered to destroy the Robot Hymie. Max is unable to do so, but he tells the Chief he has and shows the Chief a pile of parts. The Chief is suspicious and tells Max to put him back together.
What ensues is Max trying to make the Washing Machine parts look like a human being.
That is the image we should show everyone when the "Fiddle Around The Edges" "Mend it Don't End It" "We Can Repair This" idiots start their babble.
I think I'll take Sarah Palin's Stupidity over BHO's Smarts any day!
Nov '10
Re: Obamacare's Soft Opening
Pilgrim
No, Dr Lucy, they ignore "costs" of providing care and attempt to cut expenditures by cutting reimbursement. The costs are not responsive to the changes in reimbursement, as you are not doubt well aware when you pay the overhead of your practice hoping that there is something left for your draw.
Your rational response will be to limit yourself to the number of patients that you can treat each day and still maintain the standard of care.
Edited on Nov 29 at 09:58 am
You are being more precise than I. When I said "costs", I meant exactly what you say, Medicare expenditures. But I have perhaps misled you if I have implied that I am practicing medicine in a private practice setting; I am, in fact, an academic radiologist, so I have a slightly skewed view of how all this works. We take the patients we get, we work as fast as we can, and we hope that at the end of the day enough money will come in to pay the rent. I think this is how all academic medicine works.
Nov '10
Re: Obamacare's Soft Opening
Ugh. Long complicated comment just disappeared somehow. The short version is that I was trying in my original post to make the point that Medicare itself has destroyed normal market forces in medicine, and Obamacare is just the cherry on the sundae.
Aug '10
Re: Obamacare's Soft Opening
Welcome, Lucy. This trick helps me from losing comments when I feel the comments function is acting buggy: select all of the comment and copy. That way, if posting fails, you can paste what you copied into an e-mail to yourself or a text editing program and retrieve it for posting later. (Sometimes, just re-pasting what you copied into a fresh "Add a Comment" box and hitting "post" again does the trick just fine.)