5/22/2010

10 Responses to “Chicago Boyz’ New Contributor”

1. The trend to cash is very prevalent here.

   My dentist wanted the money up front for wisdom teeth removal and then reimbursed me six months later for whatever my insurance finally paid.

   The feds will have to make the trend to cash illegal if they want “level the playing field” and redistribute the care

   Steve G (7d4c78) — 5/22/2010 @ 5:24 pm

   
   

2. Wow, that’s great news.

   SPQR (26be8b) — 5/22/2010 @ 5:29 pm

   
   

3. I have been checking in intermittently with the Chicago Boyz for a long time. Will try to do so even more frequently, now. The site always has a lot to say, and a lot to think about.

   elissa (7a2c3c) — 5/22/2010 @ 5:36 pm

   
   

4. Congratulations, Dr. Capt. Mike K.!

   A Noted Intentionalist (9eb641) — 5/22/2010 @ 5:39 pm

   
   

5. Last week the Texas Medical Association reported that Texas doctors are fleeing Medicare in droves:

   Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.

   Two years after a survey found nearly half of Texas doctors weren’t taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.

   “This new data shows the Medicare system is beginning to implode,” said Dr. Susan Bailey, president of the Texas Medical Association. “If Congress doesn’t fix Medicare soon, there’ll be more and more doctors dropping out and Congress’ promise to provide medical care to seniors will be broken.”

   More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010, according to data compiled by the Houston Chronicle. Texas Medical Association officials, who conducted the 2008 survey, said the numbers far exceeded their assumptions.

   The largest number of doctors opting out comes from primary care, a field already short of practitioners nationally and especially in Texas. Psychiatrists also make up a large share of the pie, causing one Texas leader to say, “God forbid that a senior has dementia.”

   DRJ (d43dcd) — 5/22/2010 @ 5:46 pm

   
   

6. Congrats, Mike K!

   Mike LaRoche (53c496) — 5/22/2010 @ 6:08 pm

   
   

7. Congratulations, Mike K!

   Re: Dr’s fleeing Medicare
   Will we reach the point that to get treated on Medicare, we’ll have to go to the VA?
   After all, government doctors will have to see Medicare patients.
   What’s next, HHS buying up bankrupt hospitals?

   AD - RtR/OS! (3c862f) — 5/22/2010 @ 7:28 pm

   
   

8. Proof, if it was ever needed, to be careful what you wish for. Best Regards, Vaya Con Dios!

   ropelight (9d307a) — 5/23/2010 @ 5:51 am

   
   

9. A physician cannot make a living on a high percentage Medicare patient population. However, many primary care docs are finding that Medicare age people are willing to pay for good care. Practice consultants for internal medicine specialists say 11% is the optimal proportion. Any more than that and the entire segment of the practice loses money.

   To go to a cash practice, you have to drop out of Medicare completely since it is illegal to charge a Medicare patient anything extra for care. Many of the articles about this get that part wrong.

   This is working toward a market solution. The poor will have to depend on clinics. Kaiser will, the last time I heard, keep Medicare patients IF they were Kaiser members before age 65.

   Those who can afford it, and the prices are lower than most plumbers, will be able to pay cash for primary care and then use Medicare for hospitalization. Hospitals are hiring doctors, called “hospitalists”, to care for patients in the hospital since Medicare, and many insurance companies, no longer pay enough to justify spending the time for the office physician.

   This is evolving, in one way, toward the National Health SErvice, where the GP never goes to the hospital and the specialist is paid by the hospital. Thus, when you are hospitalized, you acquire a new set of doctors. It is not ideal but this is what is happening.

   The administration is so hostile to free markets that I expect them to try to force all physicians to care for Medicare and Medicaid at the government price. It may end up at the Supreme Court. Too bad the AMA sold out years ago. They could do some good. A new organization will handle the suit and the AMA will fade away.

   Mike K (82f374) — 5/23/2010 @ 7:01 am

   
   

10. Add my congrats!

    The ‘sphere is improved by those with knowledge and expertise.

    Karl (db6904) — 5/23/2010 @ 9:45 am