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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsA doctor who won't take any insurance or Medicare? Yank their license, plus imprisonment.
That's called endangering public safety.
What, that'll mean a shortage of doctors? That won't mean any difference to the working poor who have insurance but find doctors are refusing to take insurance and want them to pay THOUSANDS for medical care... money they don't even have. They won't be able to afford care anyway if more doctors start doing this.
Snatch a few licenses and put a few of these greedy fucks in prison and the rest will get the point. It'll be better than letting them face an angry mob of people (or bereaved relatives thereof) who needed care but couldn't afford it because the doctor wouldn't take their insurance.
Refusing insurance and demanding that the poor pay up thousands for care? That's bullshit. People will die if that problem spreads.
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Texasgal
(17,042 posts)It's not the docs that are greedy. Imprisonment? Seriously?
Do you have any idea how medical billing works?
nadinbrzezinski
(154,021 posts)Zalatix
(8,994 posts)It works exactly this way: if you're poor, you don't get care.
If the doctor puts you on a billing plan and you can't afford the payments, you also don't get care. Or you go bankrupt EVEN THOUGH YOU PAID FOR INSURANCE.
Name one thing I missed about how medical billing works.
Texasgal
(17,042 posts)Look, it's NOT the doctors. It's the INSURANCE companies that are denying you health.
Your anger is misplaced.
Zalatix
(8,994 posts)is getting harder and harder. The problem is growing.
Texasgal
(17,042 posts)Because your greedy fucking insurance does not pay shit for your visit. They sucking YOU and the doctors dry.
Again, your anger is misplaced.
Zalatix
(8,994 posts)Texasgal
(17,042 posts)Actually, it's our government. If they would allow more health dollars to be spent on coverages instead of billion dollar wars we may not have this issue. 
Zalatix
(8,994 posts)And the poor in America suffer when Medicare recipients have to go across hell's bells to find a doctor to serve them, when there's one nearby who could. Sure, we need to end the wars and the corporate subsidies. But right now we have a one-alarm fire that's burning in some communities and we need a fire truck out there, STAT, to deal with it. Stopping doctors from refusing Medicare is that firetruck.
And it's even WORSE that Americans will have to pay for insurance on pain of a tax penalty in 2014 and when they do pay for insurance, some of them will have to pay extra because the nearest doctor won't take any insurance.
All of this hits the poor harder than the doctors. If these are the doctors that are out there, then we don't need these doctors. We need to replace them.
Texasgal
(17,042 posts)decently? How about we allocate more money for heath care?
Let me break it down for you.
Example:
Intubation tubing COST: $5.00
(plus the staff that knows how to intubate and has an office to do it along will all the overhead)
Medicare/Insurance reimbursement: $4.00
Now, you tell me what is wrong with that?
Yes, the poor are suffering because our government is not doing what needs to be done with greedy insurance companies and no allocation for funds to keep us healthy.
STAT is stopping the greedy insurance companies. There's your fire.
Zalatix
(8,994 posts)We need to make Medicare AND the insurance companies pay properly.
Until then, though, what will a poor person do when they need care and the doctor says "cash only"?
Should they just suffer while the doctor takes out their problems on the patient? I guess so.
"Cash only. GTFO."
Texasgal
(17,042 posts)in jail because he doesn't take your insurance.
My only advice I could give to you *today* this minute is to find a doctor that takes your insurance. Throwing your doc in jail and stripping his license does nothing for you or anybody else.
And no, no one should *ever* suffer...although many do under this broken system. I can sympathize.
Zalatix
(8,994 posts)
notadmblnd
(23,720 posts)running on about Drs and them not taking medicare (which is for the disabled and seniors) payments. Give it up! You don't know what you are talking about. You post no support for your claims and you are looking like nothing more than a hysterical four year old.
Zalatix
(8,994 posts)by someone you called a hysterical four year old. That kind of sucks.
Doctors who take Medicare scarce
RALEIGH (WTVD) -- Beverly Frake moved to the Triangle two years ago from upstate New York.
"Northern winters were getting to me just a little bit," she explained. "My daughter was here, and she really liked it. She wanted me to come down."
But, she had no idea that when she became a Triangle transplant that she would be waiting to find a new doctor.
"I moved into this nice apartment complex, big medical complex across the street, I thought, 'How lucky am I?' And I went there and was told in the waiting room, well, they just didn't take Medicare patients," Frake recalled. "One of the receptionists said to me, 'Well honey, it's just going to get worse.'"
And why bring up the fact that you only get medicare if you're disabled? Being refused care is even WORSE in that situation.
Glitterati
(3,182 posts)from the date of their disability certification by social security.
Explain what a disabled person is supposed to do for those 2 years for medical care?
My disabled father DIED waiting for the 2 years to be up.
notadmblnd
(23,720 posts)Of course a Dr that performs any sort of elective surgery isn't going to take medicare, because medicare isn't going to pay for elective surgery. You are fear mongering here and claiming that all Drs are going to begin refusing medicare payments. But that's beside the point. My post was pointing out that the poor don't get Medicare unless they are disabled and qualify or the federal program. Poor children and their single mothers qualify for a program called Medicaid and there is a difference. Now how does that discredit me, smarty pants?
Zalatix
(8,994 posts)My point is that the poor who do qualify for Medicare are getting unfairly socked in the ass when they run into a doctor that won't take Medicare. OR MEDICAID, either.
That is a fact, no matter how confused and off-topic you get.
crazyjoe
(1,191 posts)
Auntie Bush
(17,528 posts)are thousands of very highly qualified students who want to become Drs. We would have no shortage of Drs. if we had more MEDICAL SCHOOLS. (Look at all the extra interns we'd have to help Drs in hospitals.) Take only students what are in it to help people and not the ones who just want to get rich. Make them take an oath that they will accept medicare patients and accept all insurance or they don't get in! Any Dr. that won't take these people or charge them extra are in it for money and shouldn't become Drs. Tell them to go to business school and then head for Wall Street if making lots of money is their goal.
Creating more medical schools is difficult and time consuming and we need those additional schools as soon as possible so...Democrats need to write some bills pronto and get the ball rolling. Too bad this will alienate the AMA who will fight this idea tooth and nail...they want there to be a shortage of Drs. to help keep their salaries high.
Pacafishmate
(249 posts)4 years of med school and then residency for anything other than exceptional pay. Unless you want to import doctors from India or China , that is. Obviously it hits the poor harder than doctors, you're just blaming the wrong people. Blame the insurance companies that don't properly compensate doctors.
Daemonaquila
(1,712 posts)I ran a medical office. Anyone who won't take traditional Medicare is a greedy ass. We had to ensure a balance of patients to counter a few areas where they paid poorly, but traditional Medicare is actually a pretty good payer overall.
However, don't talk smack about docs who won't accept certain HMO plans. The docs who do have to sign insane contracts, and may face financial penalties if the actually provide care. A while back, a whole town full of docs decided to be the great hand of the marketplace and boycott certain insurers. They lost, but they were right. If you don't like crap care, and you don't like sharing your doc's time with 44 other patients that day, blame an HMO near you. They're the scum of the earth. Look up how much they spend on overhead vs. care, sometime, and you'll get the picture.
Zalatix
(8,994 posts)When a whole town of doctors do a boycott, that hurts the people in the town.
Yes, doctors are suffering... but patients are suffering even more. It wouldn't be such a problem if it weren't growing.
I also feel that medical insurance corporations should be outright abolished. And not just because they shortchange doctors.
Honeycombe8
(37,648 posts)Or else prison? Like a prison work camp? BWAHAHAHAHAHAHA.
Let's force people into working at Wal-Mart, taking Wal-Mart tokens as pay!
Let's force people into working as landscapers, taking bags of mulch as pay!
So silly. In our country, people choose what they do for a living, and they choose the method of payment they will accept. If the govt tries to force them to accept a different kind of payment, they'll simply leave that profession and do something else.
I don't know how old you are, but it wasn't that long ago that ALL doctors required payment up front, or a financing arrangement. YOU, the patient, had to deal with the ins. company, if you had insurance (many people did not have ins.). I was surprised that dr's offices started handling the ins. paperwork, and I'm not clear on when that started happening. I'm assuming they did, so that they would get paid sooner? Or as a service to the patients?
In my area, I know of no drs who don't handle the ins. claim paperwork.
If you take your car to a body shop for repairs after an accident, you are responsible for the payment. They may or may not work with your ins. company. If they do, it's as a service to you. Some body shops require you pay the bill, and you deal with your ins. company.
Zalatix
(8,994 posts)Which would represent a ZERO change of status quo for the poor if they can't afford cash-for-care.
As for that era when ALL doctors demanded payment up-front? Fuck, I'm glad I wasn't poor and living in that era.
FUCKIN AY.
Honeycombe8
(37,648 posts)paid. WE have decided that you need to wait a month for payment for hte services you provide. First you have to fill out some forms, send the forms in, and about a month or two months later, you will get paid.
Hey, that works for US! Never mind YOU did the work.
Doctors and other people are not there for YOU, to service your every whim. They're people workin' for a livin', just like you. They need to get paid timely. They decide what and when they'll accept payment. It's simple, really. If they decide to handle insurance paperwork on your behalf, that's great. But they don't owe that to you.
BTW, when you start cussin' in a response....you've lost the argument. Debate rule #5.
Zalatix
(8,994 posts)#3, I can tell that you really don't give a rip about the PATIENTS who are refused service by doctors. Like, say, Medicare and Medicaid patients.
SheilaT
(23,156 posts)I had already filed the claim with my insurance, they gave me a list of repair places, I chose one, and only paid my deductible.
Can't imagine taking my car in to be repaired without making sure ahead of time that the insurance will pay.
Honeycombe8
(37,648 posts)the insurance. Even the rental car.
Other times in the past, I call the ins. company, they come out and look at the car, cut me a check. I take it anywhere I want to be fixed. Or don't fix it at all.
It all depends. Point is, repair shops decide what they will and will not do. And the car owner decides what he wants to do or not do. But the repair shop doesn't HAVE to handle the ins. paperwork for the car owner.
The poster seems to think that people in the service business have a duty to defer payment for hteir services, and handle the claim forms for the people they're servicing, and wait on payment from the ins. cos. They often do that, but they don't have a duty to do that.
Zalatix
(8,994 posts)Medicare.
They do exist and they've posted in this thread. Post #130 for example.
What do we do for those people? Tell them their situation doesn't exist, fuck off, go without a doctor?
Really? What does America have to offer people like that?
Honeycombe8
(37,648 posts)If I complain that I can't find a repair shop to defer payment and handle my ins. claim directly with the ins. company., and therefore the govt should force them to do that..that's the same thing as saying repair shops have a duty to take and handle my insurance. Which they do not have. It's good business for them to do that, but they don't have to do that.
SOME drs have decided not to contract with insurance companies (PPOs and HMOs). If they do decide to contract with them, they have agreed to lower fees in accordance with that contract, and the drs will usu. handle the paperwork, since they are the ones with that contract with the ins. co. But they don't have to enter a contract with ins. cos.
I don't know what to do about people who can't find care providers who have contracted with ins. cos. But I do not believe that situation exists. Give me a city....I'll provide you with a long list of drs in that area that have contracted with ins. cos. (PPOs and HMOs).
I think this is a situation that may have existed in one or two instances, where a person's favorite or long term doctor dropped its PPO or HMO contract. Give us the doctor's name....we'll look up if he takes NO insurance, or just stopped taking that particular patient's insurance.
Doctors, just like you and me and everyone, deserve to get paid for their services. If a dr stops taking insurance, all that means is that they stopped entering into lower-fee arrangements with ins. cos. The patient still has insurance and can turn in a claim for an out of network doctor. THE PATIENT STILL HAS INS. My doctor's office confirms my ins. every year when I make new appt over the phone, to ensure there have been no changes....if I've changed insurance, or if they have quit taking my insurance.
Zalatix
(8,994 posts)Here's an example:
Metro Atlanta. Post #174.
Ms. Toad
(34,057 posts)That is a different situation than being unable to find doctors who will accept insurance.
Zalatix
(8,994 posts)And it's worse in that case because those people are poor. And disabled.
Ms. Toad
(34,057 posts)But if you want to look at them as if they were insurance, each is the equivalent of a single insurance company. So using rejection of Medicare/Medicaid no more illustrates that doctors are going to a cash only model than does a doctor's rejection of a single insurance carrier.
Most doctors can, and do, pick which insurance carriers they will contract with. If the benefits aren't high enough, or the paperwork too onerous, doctors will reject that relationship. Doctors rejecting Medicaid or Medicare are doing the equivalent of rejecting a contract with a single carrier, while still accepting one or more other insurance carriers.
That is not the same as a doctor refusing to accept insurance at all (or going to cash only) - which is what you have been saying will be a problem with Obamacare. Under Obamacare people (both poor and wealthy) will have a variety of insurance providers to choose from and while it is almost certain that individual doctors will reject relationships with some insurance companies, very few will reject relationships with all insurance companies. People who are responsible for choosing their own insurance provider will need to choose carefully to make sure the one they accept covers their doctor - or the plan they can afford doesn't include their doctor they may need to switch doctors, just as I do now (and I occasionally have to now and I have very pricey employment provided insurance.)
Zalatix
(8,994 posts)Doctors reject Medicare/Medicaid more than they reject private insurance. In fact, downthread you'll find examples of where a whole city is afflicted with this problem: Atlanta, Georgia.
It's especially cruel to refuse treatment for Medicare/Medicaid patients, because they're people of little or no means. It is absolute cruelty.
Ms. Toad
(34,057 posts)It seems to be a problem - although my experience with Medicaid suggests to me that it is also partly a problem with understanding how to negotiate the system. I have a lot more non-financial resources than the average Medicaid recipient and was able to find excellent care without a problem. That isn't to say that everyone can - but that part of the problem is also not knowing how to work the system.
But - you keep insisting that we are heading toward a world in which doctors will refuse to accept insurance at all, and using anecdotal evidence of doctors rejecting to Medicare and Medicaid as examples of that trend. Those two decisions by doctors just aren't equivalent. Rejection of Medicaid or Medicare is equivalent to refusing to deal with a single insurance company. It is not the equivalent of rejecting all insurance payments and moving to a cash only business.
MADem
(135,425 posts)How would you like it if the government told you how you were allowed to take payment for your labor?
Worst OP I've seen in weeks, frankly.
Pab Sungenis
(9,612 posts)But his office visits? Only $27.00. Even when I had insurance and was stuck with their approved "primary care physician" my co-pay was twice that.
It's not the doctors that are the problem.
Telly Savalas
(9,841 posts)So yanking their license endangers public safety too, since the consequence is exactly the same as what you cite.
nadinbrzezinski
(154,021 posts)Will set up shop in South East San Diego? Really? You must be kidding me.
Second, the profession takes care of this. Unless he s in one of the specialties that never need hospital privilidges, he'll have a heck of a time getting access, due to rules for hospitals.
Third, he or she is free to do that, current changes he o she will leave the profession or change that tune. Look up North, that happened in Canada too.
onecent
(6,096 posts)Kansas City. She went to her doctor last May (same doctor's office she has been going to for over 15 years...and was denied) her Medicare. She has been on medicare for 3 years.
She didn't read what her new supplement meant (she is retired from AT & T --well, from Lucent as it changed hands back then, and just signed up for basically the cheapest one. Somehow that company absorbed her medicare and she was not able to go to the hospital 5 miles from her in Liberty, Mo and had to pay a $2500.00 deductible.
She is going to talk to my guy that talks to me every October about what I need this year.
I can't explain it much better than this, because it has been extremely confusing and definitely sent her into a deep depression.
We both go to the same Chiropractor and they said they are getting lots of people that are coming in and they cannot take their medicare because of this very thing.
nadinbrzezinski
(154,021 posts)Doctors are refusing to take certain types of insurance (including Medicare) since it does not cover costs.
That is the conversation we should be having.
Zalatix
(8,994 posts)People on medicare can't afford out of pocket costs as it is. Much less the stupid payment plans these doctors put patients on DESPITE being insured.
The poor cannot afford doctors who don't take insurance. The poor cannot afford doctors who don't take insurance. The poor cannot afford doctors who don't take insurance!
nadinbrzezinski
(154,021 posts)Because it can't afford to stay open?
The story is not refusal, but WHY. I know, shades of gray ain't your strong point, serious.
Looking at the WHOLE ISSUE matters. This has to do with payment and reimbursement schedules. You should look into that my dear. Shades, gray.
Zalatix
(8,994 posts)That's not where we're at now, but it's where we're headed as more doctors refuse to take Medicare patients, and even those who carry private insurance.
I know you have a long record of caring about the poor. You should know the math is pretty clear on this: the poor cannot afford this trend.
Texasgal
(17,042 posts)are far from rich. I could lose my ass if I was diagnosed with cancer or something, even WITH insurance.
Zalatix
(8,994 posts)Imagine it's 2014 and you earn 30K a year. You are making a $200 payment per month for private insurance which is your newly-acquired obligation according to the ACA Mandate. (Kaiser Foundation calculations say you'll be paying more than this.)
Then you get sick. Or you get hurt.
You go to the doctor and find to your horror that none in your area take insurance. Now you've got a nice fat $10,000 bill because you had to pay out of pocket.
Oh of course you can break that up into payments. Yay! Now you have your $200 mandatory payment (to avoid the tax penalty) and you also have an additional $100 per month monthly payment for medical care that your insurance should have covered!
Your cost of living just went up another $100 dollars.
Oh, wait, that first problem that hit you? There were complications. Or an opportunistic disease that piggybacked. Now you're back to see the doctor again.
Ding! You're on the hook for another $5,000! That's another $50 a month.
Isn't life great!!!
nadinbrzezinski
(154,021 posts)That's the truth, and facts don't matter to you.
Zalatix
(8,994 posts)Maybe my solutions are utopian.
Perhaps your solution is for Medicare to pay more for care, and to abolish insurance companies. Is that your solution? Then it is a perfect solution.
But right now what do we do for all those poor people who can't afford care because of the GROWING number of doctors who demand cash payments? What do we do for them? Tell them to wait? Too bad, so sad, throw on an extra monthly payment to add onto their current cost of living that they already cannot afford, or can barely afford?
Who here, in this thread, has talked at all about the poor who run afoul of these cash-only doctors?
nadinbrzezinski
(154,021 posts)And my solution is Medicare for all, tricare for all, singe payor... Working towards that. But I don't call or doctors to go to prison, that strikes of cultural revolution, the worst aspects of it.
Zalatix
(8,994 posts)nadinbrzezinski
(154,021 posts)Those who did not got out of Medicine in 1955 or so.
Oh and you obviously missed this MEDICARE FOR ALL is code for SINGLE PAYOR SYSTEM.
Zalatix
(8,994 posts)Now if we copied Canada's law as American law I could see that working. But that's what we would have to do.
I disagree, though, with anyone who believes America, as a nation, will live to see Medicare For All ever happen. Feel free to feed me crow if it does. I'll take it without BBQ sauce.
nadinbrzezinski
(154,021 posts)But I think it will... but not in my lifetime. The US has this penchant for incrementalism. Social Security in 1935 stunk to high heaven.
Zalatix
(8,994 posts)Again, what can I do but watch the world burn while doctors penalize those who rely on insurance and can't afford their cash only game.
nadinbrzezinski
(154,021 posts)and with very specific specialties without hospital privileges... WAIT... La Jolla is very well to do.
Nah your problem is not cash only docs, it is finding a doc in both rural and inner city communities.
I wish I could wear the same kind of black and white glasses you wear, mine are not rose colored either... of course there is this other problem where a lot of young docs are signing up with hospitals and large practices (that do accept medicare) since going on private practice is next to prohibitive these days.
Again, just like immigration patterns, there are oodles of academic papers on the bad distribution of doctors, especially GPs in this country. We call that policy by the way.
Zalatix
(8,994 posts)who mentioned someone spending 4 months looking for a doc who'll take Medicare.
Post #130.
What do we say to them? "Your situation is abnormal. Sucks to be you"?
At what point do we start giving a shit about those people who spend 4 months looking for a doctor that'll take Medicare?
nadinbrzezinski
(154,021 posts)Now that is so funny it is almost laughable.
I just presented to you the reality.
Yes SOME DOCTORS are not accepting medicare, and in some regions of the country that is tad more of a problem. But we are not yet, operatve word here, YET, at crisis point... reimbursement issues will make it so though.
Problem is that you refuse to even face facts. If it costs five bucks, as another poster told you to entubate a patient. which is a fairly common procedure in surgery, or in emergency medicine... and medicare reimburses you for four, what do you want the doctors to do?
At this point we are talking something in your black and white world you can't deal with... it is called policy. The solution dear is actually simple, at a policy level... make the payment schedueles go up to at least break even, if not make a little profit. This has been the complaint, not now, for the last ten years about Medicare. You may even fault the passage of Part D for part of this mess.
But I think policy has never been your strong suit. But what is your strong suit is solutions that are outlandinsh, and based on anecdotes. Granted, some of them are actually peddled out as news stories,. and the funny thang is... where you find them. They do cluster, you may want to do that exercise and you will find an interesting correlation with NATIONAL health stats as well.
And next time you acuse me of not caring, you will have stronger words from me.
I am all for solutions to problems, solutions THAT CHIEFLY WORK. It might be this being older than you, yes there is an age difference, but utopias don't work. IN all seriousness I recommend you read into the Cultural Revolution and how it happened for real. Many of your solutions come straight from there. I suspect you have not heard that before though.
Ms. Toad
(34,057 posts)And it may well have been a situation where none of the specialists accepted Medicare.
But we are hearing a second hand report of the problem. All searches (and all abilities to search) are not equal. I know that there are many times someone will tell me a resource does not exist and that they have searched for it for months and I am able to locate it in a matter of minutes or hours. I'm not saying that this is the case here - but we don't know enough details to make a federal case out of it based on a second hand anecdotal report.
The report probably does mean, at a minimum, that we need to streamline the process of connecting Medicare patients to doctors. My insurance company offers a "find a provider" search that identifies providers which accept my insurance and indicates whether they are accepting new patients. Something like that is probably needed for everyone - and if the problem reported was merely an inability to search efficiently that should address it.
Texasgal
(17,042 posts)with healthcare and health costs in general. I work as an RN I see this crap everyday.
I am really sorry that you have no faith in the medical community. I just don't understand why you refuse to see that managed care is bleeding us slowly. I'm sorry, don't get it.
Zalatix
(8,994 posts)only the rich will be able to afford care.
It's inevitable.
Texasgal
(17,042 posts)We need to get angry at the fat cat insurance companies... not the Doctors.
uppityperson
(115,677 posts)pay doctors enough to cover their bills. Go after insurance companies that deny coverage or have huge deductibles to make their insurance worthless.
dflprincess
(28,075 posts)that the only insurance you can get for $200 a month has an annual deductible of $6000 or more (I believe the legal limit is just over $6K this year, in 2011 it was $5950 and it goes up annually).
As I've said many times, the ACA never guaranteed us access to care (which is what we needed), it only requires that we buy "coverage".
(And before someone jumps in, yes the ACA covers screening tests, but there's no point in having an annual mammogram if you can't afford any recommended follow up. I know from personal experience that it can cost several thousand dollars to find out that weird spot on the x-ray is benign - but I was fortunate enought to haved decent insurance at the time so I didn't have to pay more than a few hundred out of pocket.)
Zalatix
(8,994 posts)Even though NOTHING you said was wrong...
lunasun
(21,646 posts)medical Drs and staff and the office clinic space all med equipment amd supplies and lab work( and billing work) all live off of lollipops and rainbow payments I guess 
matt819
(10,749 posts)Medicare reimbursement is one of them.
Medical billing is another.
Cash payment options vs. payment via insurance is another.
Cost of health insurance premiums is another.
MineralMan
(146,284 posts)but didn't understand it. Almost all Medicare Advantage plans are HMOs. They require members to go to doctors within their HMO group, and patients have to pay very large deductibles if they go elsewhere.
It's cheaper, because the regular Medicare Part B payments go directly to the Advantage plan, which handles all of the patient's medical care. They work for some people, but others find them difficult, and some make patients jump through many hoops to get care authorized. Right now, it's open enrollment time, and your friend can change back to regular Medicare and a supplement of her choice. That may work better for her.
You were smart to have her talk to a pro about this.
Hoyt
(54,770 posts)There are some doctors who are not accepting Medicare, but most do (in fact, most of the docs who got rich in the 70s and 80s did so because of Medicare when it paid just about anything most doctors billed) -- and a whole lot that won't touch Medicaid because it pays 20 to 30% less than Medicare.
More and more private insurers' rates are starting to reimburse physicians' less than Medicare rates. I suspect some docs are beginning to refuse those patients.
Doctors can still make a very good living off Medicare, but it's not like it used to be. Consequently, more and more are selling out to hospitals and even insurers and working strictly for a salary vs. owning their own practice and taking th risks associated with that.
Sooner or later, the government is going to be forced to take over if trends continues.
cthulu2016
(10,960 posts)Castrate a few, stuff their genitals in their mouths, and tie them up in conspicuous places. Toss an ace of spades on the corpse as a calling card.
That will get their attention.
And any village found harboring a doctor, we can shoot every tenth villager in the public square.
Nobody will elect to go to medical school, of course, but the state can identify promising students and send them to some sort of educational camps.
MH1
(17,595 posts)Doctors are not the "greedy fucks" here. We have a profit-driven system that is treating medical personnel as a commodity but refusing to pay sufficiently for the resource. The resource is not going to be available to them at the price they want to pay.
Zalatix
(8,994 posts)The money is not there. It's simply not there. Stuck in an area where doctors won't take insurance payments, what are they going to do?
You're paying for insurance and the doctors in the area still won't take you. WTF. Do you not see the problem with that?
What good is the resource if you can't afford it?
MH1
(17,595 posts)And get rid of for-profit insurance.
What is unclear about that?
Doctors have to feed their families too. If doctors won't take insurance, it is because insurance isn't paying enough. If someone can't find a doctor, maybe it's because the sacrifices to become a doctor just aren't worth it for low pay, extremely long hours, being on call essentially 24/7, and constantly being threatened with a) malpractice suits or b) having your livelihood fucked with because someone thinks you overtreated someone's genuine pain. Oh and not to mention being trapped in your chosen profession until you pay off $100,000 or so worth of student loans.
Family practice docs are getting FUCKED in this system. Yeah it is bad for the poor people who can't get care. But don't call the doctors "greedy fucks" when they are the ones who went to school for a gawdawful number of years just to get fucked over by insurance companies and the congress critters that SOMEBODY elected. (Did those poor people vote? Did they vote for people who won't fuck over doctors? Do they support single payer?)
Zalatix
(8,994 posts)But you can rest assured that the posters on DU you are arguing with are of course comfortable enough that they don't have to worry about such things! Why should they waste their beautiful minds on it? If the poor wanted medical treatment, well, they should have thought about that before deciding to become poor.
nadinbrzezinski
(154,021 posts)And the so called solution by the OP will destroy an already teetering system.
And I mean the real front lines.
Zalatix
(8,994 posts)nadinbrzezinski
(154,021 posts)It might not be your preferred way, doctors should work for free, but it is already under way.
It is not my preferred way, but it is reform already.
Zalatix
(8,994 posts)nadinbrzezinski
(154,021 posts)but you knew that.
Texasgal
(17,042 posts)What a broad brush shit smear!
Nobody knows my situation and I never said that I wanted the poster to suffer. Jeez.
Scootaloo
(25,699 posts)My apologies for ever doubting your place as the next incarnation of the Mahatma, Texasgal. I was expecting someone... balder.
Zalatix
(8,994 posts)Texasgal
(17,042 posts)You obviously haven't read my posts. Am I surprised? Nah...
Your tripe is still a pantload of smeared broad brush shit. No matter how you put it.
Scootaloo
(25,699 posts)I just haven't seen the ones where you give a shit about the question posed.
But I'm sure that, since you're the patron saint of compasison, I shoult take you at your word and be done with it 
MH1
(17,595 posts)what the fuck is up with that?
I guess in your world, every doctor is filthy rich and never works a minute more than an eight hour day?
Do you even know the difference between a family practice doctor (the guy/gal you want to work for almost nothing) and a specialist (some of whom actually fit your apparent stereotype)?
You can't ask ANY skilled practitioner to work for free, or for less than their costs of operation. You want that, move to a country that works that way. But guess what? MOST doctors do A LOT of pro bono work. Of course you don't give a shit about that. Won't take insurance? Won't take Medicare? Throw 'em in jail! Off with their heads!
On the other hand, if we had a reasonable single payer system, the government could actually hire enough doctors to support the need. And if there weren't enough skilled practitioners to be hired, incentivize medical training and pay more. But that would mean - gasp - they would have to ask people like me to pay higher taxes! Oh the humanity! For the record, I make a far better income as not a doctor, than my relative the family doc makes. With easily less than one-tenth the occupational stress. And doctors now have to put up with shitty stereotypes from the public that they are "greedy fucks" because they actually want to earn a living and pay off their student loans. No wonder no one wants to be a family doc anymore.
When no one goes into family medicine any more, who will the poor get their care from then?
Zalatix
(8,994 posts)The doctors are taking it out on the hides of the PATIENTS.
The doctors are taking it out on the hides of the PATIENTS.
I can't POSSIBLY repeat that too often.
backwoodsbob
(6,001 posts)do you have any clue how much money a family practice doctor has to pay out every year?
I'm in the last stages of getting into boeing and once I get up to scale I will make as much as a general laborer as most family doctors make.
Your solution is to force family doctors to bankrupt themselves paying for patient care out of their own pocket at the threat of imprisonment.
Who the hell would ever go through what it takes to become a doctor if it means guaranteed bankruptcy for the doctor?
THE DOCTORS AREN'T THE PROBLEM!!!!
The problem is with out insurance/medicare system
Zalatix
(8,994 posts)Stay the course, or try another solution, while people keep getting stung by cash-only doctors?
MH1
(17,595 posts)I hope that your own doctor realizes what kind of person you are, maybe they will choose to treat a poor person instead.
Actually, on edit, let me make another suggestion: get your own ass into medical school and become a family practice doctor. Convince all your friends and relatives to do so also. Then you all go work in these underserved communities, take Medicare, Medicaid, and any insurance that walks through the door. Have fun with the gazillion different rules you have to deal with for EACH ONE of these entities, just to get reimbursed - maybe - after months, sometimes.
If you are too old to go, make sure your kids go. And if they don't go to med school, succeed and become family practice docs meeting your requirements, then you can include THEM in your scathing indictment.
Zalatix
(8,994 posts)Scootaloo
(25,699 posts)It's a good question. If a person's doctor refuses their insurance - medicaid or other - what are they going to do, while waiting for this "reform"?
Yes yes, Zalatizx is over the top with the "send them to jail" stuff, but here at least, he posed a legitimate question.
So what about the person who cannot pay and has their insurance denied?
Your advice is emigration. Oh yes. Yes, because people who can't afford the doctor in their town are going to be able to zip on over to Denmark or wherever so fucking easy. Maybe you can bake a cake for them to eat along the way. or, rather, maybe you cna have the help bake them said cake.
And yes, if we had single-payer, it wouldn't be an issue. Then again, if we discovered a panacea that cures every ailment known to mankind, that can be distilled from plain ol' water, that would help too. I'm not sure which of these miracles is likely to happen first, but feel free to hold your breath for the duration.
In the meantime.. what's the poor person going to do?
Texasgal
(17,042 posts)Look, this isn't rocket science. Find a doc that will accept your plan.
Zalatix
(8,994 posts)Post #130.
What do you say to that? "Sucks to be you" or something?
http://abclocal.go.com/wtvd/story?section=news/abc11_investigates&id=8656615
1 out of every 2 doctors not taking Medicare.
What do we say to that? "Go find a doctor"? Well effing ay, people are looking for doctors who take Medicare. Half of them won't.
Kaiser says 1 in 3 doctors won't take Medicare.
http://www.kaiserhealthnews.org/stories/2012/august/06/third-of-medicaid-doctors-say-no-new-patients.aspx
nadinbrzezinski
(154,021 posts)get CONGRESS, yes CONGRESS, to aprove an increase in the reimbursement schedule. This is a POLICY problem manufactured by CONGRESS.
There is a solution, but you knew that. The problem is that you, and the OP mind you, are blaming docs for a problem at a very high level of our government.
Scootaloo
(25,699 posts)Where did I blame doctors? I actually disagree with Zalatix's "GET THE DOCTORS!" rhetoric, and said as much. Maybe, maybe if it weren't so dark in the cavity where you keep your head, you could see better. But then I suppose, that would make it harder to push the "fuck you I've got mine" horseshit you and others are shoveling on this thread.
Yes, there is a "solution," that's awesome. But what happens in the meantime, Nadin? What happens if your solution fails in congress, as it's almost bound to?
Will you suggest, as MH1 did, that the people too poor to afford a doctor, whose insurance doesn't help, should just HOP A JET TO ANOTHER COUNTRY for medical care? A weekend jaunt to Norway or Brazil, you know, nothing unusual except for the stop at the doctor's office.
nadinbrzezinski
(154,021 posts)I no longer bother with alerts on obvious trollish personal attacks. Have a good life.
Did not get beyond your personal attack... have a good life.
Scootaloo
(25,699 posts)Good riddance to you as well!
cali
(114,904 posts)So how about the care I've been given? Last year I one of those infamous in home accidents. Fell at the top of the stairs, landed with my left leg somehow outstretched and smashed it into pieces- the fibula and the tibia. Compound break plus I had to crawl up the dirt lane at night to get help. Ambulance to the hospital. 4+ hours in surgery while they put the leg back together again with a titanium rod inserted up the middle of the tib. Excellent Ortho surgeon. Long story short, I had non-union breaks and they didn't heal. Had more surgery in March and then a pretty major surgery- bone graft, replacement of the rod, plate on the fibula- at the end of June. Medicaid paid for that and more: 30 sessions of PT, medications, electro-magnetic bone stimulator. No co-pay on anything. I'm incredibly grateful. Developed a neuro-vascular condition called complex regional pain syndrome. Medicaid is paying for the specialty care for that. It's all sucked but thank god for Medicaid.
The surgeon I went to is part of what's probably the best known orthopedic group in Northern Vermont. My primary care doctor who is the same dr I've been seeing for close to 30 years is part of the Dartmouth-Hitchcock organization and is terrific. I first started going to that practice when I had BC/BS through work.
Zalatix
(8,994 posts)That's my point... what doctors are doing is unbelievably cruel to the patients.
cali
(114,904 posts)what if I'd died from the fall? What if, what if, what if. Furthermore, I had no insurance at all when it first happened. It took a 6 weeks to get it. My dr. and the hospital saw me regularly during that period and I applied for and got aid from the hospital so I didn't have to pay for the hospital stay (5 days) or the or costs. My doctor also reduced the amount I owed.
And as people have explained to you over and over and over again in this thread, the chief fault lies with insurance companies and underpayments to doctors from Medicare and Medicaid. Are there some greedy docs? Sure, but you have provided exactly no evidence that this is either an overwhelming problem or the root of the problem.
Zalatix
(8,994 posts)"it doesn't happen very often" as you say, so to hell with their problems. Gotcha!
cali
(114,904 posts)And then you despicably put words in my mouth? Fuck that, sweetheart.
Zalatix
(8,994 posts)You're the first one to go on my ignore list.
uppityperson
(115,677 posts)I agree "What good is the resource if you can't afford it?" I disagree that doctors are "greedy fucks".
southernyankeebelle
(11,304 posts)Sometimes people forget the doctor has expenses also. They have to pay for their own equipment which is expensive to stay up to date. They have to pay their employees. My relative said she would love to get health insurance for her staff but she just can't afford it. Their insurance fees are very high if something happens to a patient and they sue. She has been lucky she never has been. Here is the kicker for her. Two years ago she had to have her breast removed for cancer. You can see how having to worry about that and all her employees will not be working. She had another dentist working for her but he went on to further his education. That happened about the same time. She couldn't afford to stay out to long. Finally she was lucky enough to find a dentist who only wanted to work a couple of days. Once she was feeling better she was able to work 3 days a week. She went back to work little early. But everything was on her shoulders. So I can see a doctor's point of view. But still patients need care and I think its a right everyone should have. There has to be a way everyone rich or poor gets healthcare.
bluestate10
(10,942 posts)You relative faces the reality of a private medical practice. Dentists and doctors come out of school with large bills for education. If they set up a private practice, they have large bills for equipment like x-ray equipment, examination tables, tools, and so forth. Then they have salaries of office personnel and assistants. If the practice is booming and the client base pays their bills, the practice makes a profit. If clients don't pay, or if the practice gets lots of people paying at reduced rates, the practice struggles to break even. That is the reality.
What can realistically be done about the problem. First, medical and dental educations should be free, paid for by the government. Medical students can chose to opt out of the free training and the agreements that follow after that free training. Once done with medical or dental school, new doctors or dentists go work at public clinics for 7 years, free from malpractice insurance payments and using equipment paid for by the federal government, office staff paid for by the government and assistants paid by the government. In return, the doctors treat patients for a fixed rate paid by the government. This idea has some holes and I am sure the naysayers will find them, but a system built like this one must be put into place if the issue of health care providers economic well being and affordable health care for all americans is to become an everyday reality.
southernyankeebelle
(11,304 posts)My sister does help the community with people who don't have money. But we have to find a way. People shouldn't have to hurt because they don't have he money.
Manifestor_of_Light
(21,046 posts)There is one in Palestine, Texas. His office woman gave me some line of crap.
I went elsewhere. I could not believe it.
treestar
(82,383 posts)Probably a dum dum out front.
I always love business that refused to take traveler's checks. They didn't understand what they were. So they'd take bounceable personal checks, but not traveler's checks.
Honeycombe8
(37,648 posts)I find it weird, too. I imagine part of the reason is they don't have the procedures in place for security, to protect against theft, and to deposit it (it has to be dropped off at the bank personally). Not to mention giving change.
Most things are electronic these days.
SheilaT
(23,156 posts)If I ever were to have my cash refused, despite the fact that, wait let me double check this . . . Yep. My bills all say "This note is legal tender for all debts, public and private." If a business refused my cash, I'd not only not patronize them again, but I'd look into what can be done for their illegal refusal of my money.
Honeycombe8
(37,648 posts)My life has much bigger concerns. I don't know what you call "small." I call "small" less than $10, so we're talking about convenience stores or fast food places. Both of those types of places have cash registers and are able to, and do, take cash. But if they would only take plastic, that's fine. I don't care. (I don't eat at fast food places, though.)
The types of places with cash registers take, well, they're called "cash" registers. If there's no cash register, they don't take cash, usually. You wouldn't either...have to pay your employee overtime to run tht $3.00 to the bank (plus spend $ on gas to get it there).
SheilaT
(23,156 posts)they didn't have a cash register. Even at a car dealership, where usually financing is arranged, they're taking cash as well as credit and debit cards in the parts and service departments.
I find that by using cash for almost all of my day-to-day expenses it is far easier to manage my spending. I honestly think that the change to debit cards and using one's smart phone to pay for stuff simply allows people to spend money they wouldn't spend if they were to use actual cash instead.
People who complain they can't save and don't have any extra money, and yet constantly use the debit card for every little purchase are not in good control of their spending. If they'd switch to cash, and set reasonable limits on themselves, they'd be surprised at what a difference it could make.
Nye Bevan
(25,406 posts)
marlakay
(11,446 posts)For cash.
cherokeeprogressive
(24,853 posts)Let's take all the smart kids and channel their education into the medical field. When they graduate from medical school, we can put them into locked buildings and force them to provide medical care for free for the rest of their lives.
I see no problem with that since, fuck, it will have been US who provided the schooling, right?
treestar
(82,383 posts)If a doctor can survive by just taking cash paying patients, in a free society, they have a right to do that.
In fact, they may not even be the richest doctors. Suppose a doctor set up a small practice and catered to the uninsured? Such a doctor would have to have reasonable prices and a lot of patients, but that could work.
Glitterati
(3,182 posts)Like this amazing center in Atlanta:
Our Story...In 1995, Dr. Bill Warren left his private pediatric practice in Sandy Springs to fulfill a calling; he wanted to serve Atlanta’s neediest residents. In 1998, the Good Samaritan Health Center was established and opened for service in 1999 with a staff of eight and a handful of volunteers. The Center has grown rapidly, with more than 24,400 patient visits in 2011.
http://www.goodsamatlanta.org/
He's my daughter's pediatrician.
Sadly, she'll have to move to a GP next year.
Phentex
(16,334 posts)it's done by the physicians as a courtesy.
treestar
(82,383 posts)as a way to pay it.
Ms. Toad
(34,057 posts)It may be the case with some insurance companies, but for most group policies it is the obligation of the doctor. The claims need to be submitted with coding and information which is not accessible to individuals. Every time I have had to become involved in clearing up insurance payments because they were submitted incorrectly by the provider I have been very clearly informed that it is something the doctor (or the doctor's billing service) must handle - the insurance companies have also refused to permit me to speak with the individuals who could tell me what should have been billed so I can relay the information to the provider so the provider could rebill it.
I have had individual insurance where the claims were my responsibility, but by and large that is not the case.
The other reason it is not the patient's responsibility is that most providers have contractual relationships with insurance companies through which they have agreed to accept as little as $.05 on the dollar as payment in full. If the claim is submitted directly by me, the doctor's office may not credit me with the discount (up to 95% on the bills I have been tracking recently), so even though the insurance company believes the doctor has been paid in full, and the doctor agreed to accept it as payment in full for any patient using that particular carrier, if the step in and file the claim directly the doctor does not necessarily know to apply the discount.
treestar
(82,383 posts)I have a very high deductible, but still show the insurance card, since they act like they must have it. They send it to the insurance company. Then I get this statement. I end up paying out of pocket (since it is below deductible) but at a somewhat lower rate.
Thanking the goddess I've never been near the deductible, but if so, I wonder if it's taking me longer to build up to it due to doing things this way.
Ms. Toad
(34,057 posts)Each provider that accepts a particular insurance has negotiated rates with that company which are substantially discounted from the billed rates. (More on that in a second). On labs the rates I'm seeing are typically 5-20% of what is billed. For doctors it is 80-90% of what is billed. So because you have insurance you get the benefit of the negotiated rates. It will take you longer - but you are getting credit for everything you actually pay.
As to the billed rates - because the insurance rate (and Medicaid or Medicare rates) don't always actually cover what it costs to provide the service, those added costs are generally tacked the bills for cash customers (so what everyone is billed is more than it costs for what you are provided - and the extra collected from cash customers makes up for the bulk of the business which doesn't pay for itself). Sometimes if you are a cash customer you can negotiate a lower rate with the provider. The one time I tried, the doctor refused to come anywhere near the insurance rate. My daughter needed jaw surgery. The doctor would have accepted around $2000 as payment in full from the insurance company - but it was a 2 year process (two surgeries), and he dropped the insurance company after the first surgery and before the second. We didn't want to switch doctors mid-procedure so we tried to negotiate - he would only drop from his billed rate of around $10,000 to around $6000. He considered the true cost of the procedure, and was willing to forego the extra $4000 he tacked on to make up for insurance etc. shortfall - but he was not willing to accept the insurance rate.
Fortunately we found another provider who was twice the surgeon the jerk was so it was actually the best thing that could have happened - but it was nerve wracking at the time.
Ms. Toad
(34,057 posts)Insurance is far more than just a method of payment. Insurance is also a complex scheme of discounts and cost control. Just one piece of that is how much doctors will accept as payment in full. Insurance discounts are as high as 95% of the bill (in the bills I have been tracking the past year).
mike_c
(36,281 posts)If you don't like their business model, take your business elsewhere.
jberryhill
(62,444 posts)
lynne
(3,118 posts)- what the OP may be too young to remember is that it wasn't so long ago that this was the norm and Dr's. didn't take insurance even if you had it. The doctor provided the patient with the diagnosis and billing statement and the patient submitted the claim to the insurance company. The insurance company then paid the patient direct. This would eliminate a good bit of physician expense and may result in decreased physician fees as they would no longer have the expense of processing insurance paperwork.
The patient was responsible for paying the doctor, either at the time of treatment or via an installment payment plan.
cpamomfromtexas
(1,245 posts)After trying for 3 years to find competent care in mainstream medicine after being poisoned by levaquin & cipro including tendon rupture, muscle tear, and autonomic, central, & nervous system damage. He is one of only 50 doctors in the country that is qualified to perform certain procedures. I can pay up front (thank God). but I'd really like my insurance company to treat it at in network.
For those who can't pay up front and have my condition? I have no idea how you help that short term unless you establish more new medical schools. All three of my kids want to go, but I'm going to encourage them to go the osteopathic route.
Ms. Toad
(34,057 posts)"I'd really like my insurance company to treat it at in network."
Your insurance company may well not cover certain doctors (doctors affiliate with certain insurance companies and rates are "negotiated" between them. Other doctors are treated as out of network). In addition many procedures (chiropracty, accupuncture, etc.), and since you suggest you are out of mainstream medicine my guess is that that the barrier is on the insurance company's end, not the doctor's end. That is a different discussion.
As to your kids, you are aware that osteopaths are still mainstream medicine, right? They are more open to a wholistic and manipulative routes, but they are still mainstream. In the primary care realm, my current GP (paid by the insurance company - and the best at their own game I've ever encountered) is an osteopath. In the specialist realm, I am aware that the Cleveland Clinic (not known for being outside of mainstream) has a number of osteopaths on staff.
cpamomfromtexas
(1,245 posts)And judging from the excellent care I am finally getting, I'd have to say they are right.
The state board harasses them mercilessly too.
For the record, I was poisoned by an MD and a different DO (oh and of course the pharmaceutical companies that created this crap).
You have no idea how many eye rolls those of us get when we tell traditional doctors when our problems started.
Story about a friend of mine:
http://www.levaquinadversesideeffect.com/2012/01/11/levaquin-off-label-use-and-misleading-promotion/
Ms. Toad
(34,057 posts)I'm not disputing that.
But DOs as a profession are very much mainstream. (Aside from probably some condescension because Osteopathic Schools are perceived to have lower admission standards) they are treated identically by insurance companies, hospitals, and their peers. The two who have cared for me were no less drug happy than the MDs who have cared for me. You may have found a unique DO who is not mainstream, but being non-mainstream is not inherent in the profession. The state board harassing them should tell you that. I have also found unique MDs who are not mainstream - and they also feel harassed by either their peers or the state boards.
ETA: It is an MD, by the way, who expressed concern about long term use of flagyl - in the same class as Levaqin -for treatment of my daughter's illness which is considered untreatable (the drug is being investigated - and her liver does seem to respond to it). It was her DO who first put her on it (for other reasons for which it is considered proper treatment).
Ms. Toad
(34,057 posts)The link you pointed to upthread agreed with you about Medicare, but not insurance.
There are not enough rich people in this country to keep doctors in business if they are not accepting insurance. It is possible that a doctor doing general practice could get by with direct pay, but any specialist whose fees range in the high hundreds to thousands a visit (not to mention associated hospitalization costs) cannot survive on direct pay. There just aren't enough wealthy people to pay the bills. Doctors who do not accept insurance are few and far between, and there really is not much potential for growth outside of the boutique firms where wealthy individuals essentially pay to have a doctor on call.
The only sources I can find which suggest doctors outside of these boutique firms are refusing to accept insurance are right wing sources trying to scare people about the Affordable Care Act.
nadinbrzezinski
(154,021 posts)Texasgal
(17,042 posts)myself.
I work as a surgical nurse for a large cataract practice, I am going to go out on a limb and say that 95% of our pts. are medicare as this is usually a procedure for geriatrics.
Zalatix
(8,994 posts)Cash-only physicians increase as managed-care woes mount
RENTON, Wash. - When Chuck O'Brien visits his doctor, they talk about his aches and pains, but never about his health insurance.
That's because his doctor only accepts cash.
Dr. Vern Cherewatenko is one of a small but growing number of physicians across the country who are dumping complicated insurance contracts in favor of simple cash payments.
When O'Brien leaves the exam room, he writes a check for $50 and he's done - no forms, no ID numbers, no copayments.
.....
At least around here it is. Owns all the neighboring county papers, as well as ours, and as right wing as they come.
Ms. Toad
(34,057 posts)not a study which measures a trend.
Even as anectodal, it refers to a "small but growing" number and the only specific numbers mentioned were 1500 doctors (out of 954,000 in the country) who are members of an organization which doesn't reject cash entirely - but directs patients to doctors who offer discounts for cash payments. The doctor who founded the organization has insurance (high deductible) coupled with a Health Savings Account - he is not advocating abolishing insurance (or that doctor reject patients with insurance) - merely a rethinking whether we should be using insurance for minor routine care. http://www.afcm.org/cherewatenko.html
I'm still not seeing anything which indicates doctors refusing to accept insurance is (or is becoming) a significant problem.
nadinbrzezinski
(154,021 posts)Schedules have not kept up with inflation... but it is not in a crisis mode YET. Most of it is absorbed by other programs such as medical, and and other programs. It will reach crisis point, from what I understand in ten to fifteen.
The solution is surprisingly simple, but not shocking, to you I am sure... guess who has refused to adress it? For the OPs benefit, CONGRESS. Yup, it is yet another manufactured crisis.
Ms. Toad
(34,057 posts)But the particular point I was addressing here is that there is a distinction between Medicare and insurance (whatever the source of the problem for Medicare is). Given the cost of care, I find it nearly impossible to believe that any doctor with a significant portion of practice outside of routine office visits could survive without guaranteed income from insurance payments. I just don't see that there will be a shortage of doctors refusing to accept clients with insurance.
nadinbrzezinski
(154,021 posts)other nations do, have a national health policy, like an Industrial policy, we lack both. Oh and single payor care.
Ms. Toad
(34,057 posts)
In the mean time, I'm holding my breath to 2014 when the vast majority of people will at least have access to insurance (and the poorest will be subsidized so they can actually use it to start bringing costs down.
nadinbrzezinski
(154,021 posts)
Care Acutely
(1,370 posts)I haven't read the thread yet, but I'm confident the reasons why have undoubtedly been well outlined above.
JoeyT
(6,785 posts)that give the doctor such a hard time over billing that they actually lose money by accepting patients that use them. Literally the amount of time their employee spends repeatedly filing outweighs the amount the company will pay them.
The answer isn't to force the doctor to take that insurance, it's to drop the hammer on shady insurance companies. Send them an "Act right or be nationalized, scumfucker!" type letter, and when they fail to act right strip them of their assets and jail their corporate execs.
On the doctor side, I'm far more annoyed by doctors that won't deal with anyone that doesn't have insurance. (Won't take cash) They know they're going to order a shitload of tests to diagnose a cold, and someone paying cash isn't going to want fifteen X-rays and a blood test to be prescribed cough syrup. ETA: If you're worried about the poor, this is the group of doctors you're going to want to chase through the streets on horseback. There's a huge range of poor between poor enough to qualify for medicaid and doing well enough to afford insurance. The whole "If I get sick, I'm probably going to die." range.
procon
(15,805 posts)Since most hospitals and ancillary medical providers must be accredited under Medicare guidelines to participate in the program and get paid, it would be far more effective to simply block those non-compliant medical providers from using those accredited facilities.
Patients aren't going to use a physician who can't admit to a hospital, or write Rx's, and is banned from using outpatient labs, xrays and other modalities. So, POOF... he's either out of business very quickly or he gets with the program and the cost to taxpayers is negligible.
mainer
(12,022 posts)A doctor who's forced to work for low pay won't find it worth his while to spend 12 years in school... to train for a profession that pays nothing.
cbayer
(146,218 posts)only leverage they have is to refuse to deal with organizations and companies that don't pay them enough to even cover their expenses.
You really don't understand what is going on out there.
Might I suggest you spend a day with a family practitioner in your area.
Your call for their heads is completely off base.
jsmirman
(4,507 posts)My father took most forms of insurance and definitely took medicare - why? Because he was, at least near the end, a great doctor and a lousy businessman.
I had to decipher, organize, and sell his practice when the time came. So I have more than enough first-hand knowledge of what medicare payments look like. They're pathetic. Painfully low. Like make it impossible to run a practice low.
My father was always in it to be a good doctor, and he did clinics his entire life, and, as noted above, served an entire half of his practice that paid out at medicare rates.
Let me tell you, pretty damn hard to find anyone who would take on our medicares, as it can cripple a practice if you can't move them through efficiently enough to avoid taking a significant loss on each medicare patient.
Ultimately, we were able to place them because we give a shit and because part of my father's legacy was making sure that the patients he had done so much for were taken proper care of after he was gone.
But the medicare payouts are often criminally low. Doctors' offices have *significant* overhead, that the OP seems to be unaware of. I wish everyone took medicare, like my father did, but I also understand that with monthly rent/maintenance, nurse pay, lab costs, x ray machine costs, other monthly rental payouts you have to make just to operate a doctor's office - getting 17 bucks for a procedure you would normally charge $125 for really sours you on taking medicare. If, unlike my dad, you have even a tiny bit of businessman working there.
Currently, my solution is to ask that people take a certain percentage, like 25 to 30% of their practice, to help service medicare patients. But the payouts are fucked up.
Texasgal
(17,042 posts)all those claims that must be coded to the "T" or they are denied or slapped back. Coding for medicare is like the worst most confusing tax code you've ever seen! You also have to wait up to 90 days for reimbursements in many cases. Can you say cash flow? Bills are due every thirty days, employees need salaries every two weeks...and on, and on..
It's tough for a small practice. Kudos to you dad for paying the price of medicine! He sounds like a heck of a fellow!
jsmirman
(4,507 posts)but I'm afraid there was also the sense that he was part of a literally dying breed.
You're so right about the coding.
You best believe part of that overhead is paying a skilled coder who can handle the labyrinth that is the medicare reimbursement system.
Those coders don't come cheap because that is a seriously skilled trade and the good ones are in very high demand.
And again, you are right about the timing problem, and the resulting cash flow problem. Anyone who knows anything about business understands the constant damage that this kind of payout timing causes.
It also reminds me of an old accounting prof's explanation of Gimbel's pre-shutdown: "yes, the customers were coming in and out, every day, but the register and the payments could not keep up with the overhead." (essentially, just because customers are coming in and out regularly, doesn't mean that a business isn't in serious cash flow distress).
bluestate10
(10,942 posts)If your father had nurse, equipment and office help paid for by the federal and state governments, asking $25 dollars to see a patient would not be a burden for him since a good doctor can work 3-4 patients through in an hour. Also, free training to be a doctor would eliminate large loans. Reform of malpractice laws would help, or having the government serve as a malpractice buffer, with the government having standards to insure provider competence.
jsmirman
(4,507 posts)it's tough for me, because I'm all about the citizen's right to sue, but I have seen how out of control malpractice law can be.
You literally cannot be in the business and not get sued by a couple people, and my father was a very, very well-respected doctor who won numerous national awards, but much more importantly, was loved by 99.99% of his patients.
He's gone now, unfortunately, but the point about assistance for young doctors coming up is a very important one.
backwoodsbob
(6,001 posts)hyperbole much?
Zalatix
(8,994 posts)Nye Bevan
(25,406 posts)should go to prison?
Do you realize that even if you are asked to pay the doctor upfront, you will still be able to file a claim under many insurance policies, and be reimbursed?
And what about auto body shops that don't deal directly with auto insurance companies? That make you pay for the repair upfront and file a claim for reimbursement? Send their owners to prison, too?
OhioChick
(23,218 posts)My general physician has been one for only a handful of years. His salary is approximately $80K/year. (Not counting medical malpractice insurance, office overhead, etc.) He spent about 12 years in school and has well over $100,000 in student loan debt and has a hard time making it.
Not all physicians are greedy fucks that need their licenses snatched.
Here are just a few examples of "greed."
UnitedHealth CEO paid 1,737 times average worker
http://www.bizjournals.com/twincities/news/2011/12/19/unitedhealth-group-hemsely-salary.html
UnitedHealth profit soars 155%
http://www.startribune.com/business/51360167.html?elr=KArksLckD8EQDUoaEyqyP4O%20%3Cimg%20src=&refer=y
Glitterati
(3,182 posts)for medical students.
They get a full ride on tuition to medical school, plus living expenses.
In return, the US gets GPs who will give us the 2 years in an underserved population.
How do I know? Because my sister is in medical school right now on this program - 2nd year.
Zalatix
(8,994 posts)Glitterati
(3,182 posts)I do know that the competition to get in is fierce, but it's an amazing program! Only 300 nationwide qualify.
My sister is an amazing individual who worked her ass off to get in, and deserves every accolade possible. She graduated from Georgia Tech with honors, and that alone is no easy task!
Care Acutely
(1,370 posts)I'm on the same program as a nurse practitioner.
Glitterati
(3,182 posts)And, congratulations! on being selected.
matt819
(10,749 posts)If an individual doctor in private practice chooses not to take or process insurance, or doesn't accept Medicare patients, that's a valid business decision. You may not like it, but it's a valid business decision. I hate it that my local bookstore carries books by wingnuts, but it's their right to do so.
By not agreeing to process insurance claims, he keeps his costs down. Again, a reasonable business decision. He's not stopping patients from filing claims with their insurance companies. He's just not doing it for them.
As for Medicare/Medicaid, refusing those patients is his right. Reimbursements aren't high enough to compensate him for his time and resources to provide medical services. It gives him much greater control of his business.
All of these choices also allow him to make decision to provide treatment at rates he feels is fair and reasonable. If people are able and willing to pay for those services, then all is well. If he chooses to reduce rates for selected patients, for whatever reason, he can do so because he is making his full rate from his other patients. In his community that may be a perfectly fine model.
This apparently bothers you, but business owners have the right to not do business with people, as long as they do not violate the law or civil rights in doing so.
Yes, there is a need for more primary care physicians in underserved areas throughout the United States. This is all the more obvious when you see photos of these free health care clinics. But it's not the fault of individual doctors who make valid and legal business decisions to cater to other markets. And it's not the responsibility of private practice doctors to solve the health care crisis.
Does this indicate that the system needs work? Absolutely. But when a medical education costs hundreds of thousands of dollars, don't expect new doctors to hang out shingles and work for free or for barter.
Phentex
(16,334 posts)poor people don't HAVE thousands of dollars to be fleeced by their doctors. You can't get blood from a stone.
Zalatix
(8,994 posts)Glitterati
(3,182 posts)Those people didn't go into medicine to help anyone. They went into medicine to get rich. Nothing more.
Zalatix
(8,994 posts)But in the short term, the poor are going to take it on the chin from all this cash-only crap.
Especially those on Medicare...
Glitterati
(3,182 posts)That is far worse.
Zalatix
(8,994 posts)If you're on Medicaid you will just have to wait until that pie in the sky Medicare for All thing happens.
This is EXACTLY the problem I am pissed off about.
Ms. Toad
(34,057 posts)From birth through age 8 she was on Medicaid. We never had a problem finding either primary care or specialists who would take Medicaid. Her primary care doc did refuse, for a year, to refer her to a specialist - but that had more to do with his underestimation of the seriousness of her illness. I say that because, years later, he was still suggesting that we were swatting a gnat with a bazooka. Medicaid prejudice did play a role in his response when I insisted she go to a specialist - I was handed a phone book and told, "good luck finding someone who would see her." The first specialist I called took her on as a patient and diagnosed her chronic illness in under a month and cared for her until she turned 21 a little over a year ago.
Glitterati
(3,182 posts)But, the same is NOT true everywhere.
Let me share a story about OUR experience.
My Dad was deathly ill with MRSA. His doctor who ignored the infection for MONTHS, abandoned him IN THE HOSPITAL. Called his room after admitting him and told him "find a new doctor. I quit."
I kid you not.
Then, to make matters worse, the ONLY doctor in the area who would see him IN THE HOSPITAL, because of Medicare, was more concerned with protecting the doctor guilty of medical malpractice than treating my Dad. Literally told him he would DIE in that hospital if he didn't transfer to the hospital where he got the infection from surgery.
The rest of the story is even worse. But, I'll leave it there so you can understand just how lucky you were.
Ms. Toad
(34,057 posts)My father-in-law had similar challenges. He died as a result of malpractice and the doctor altered his records to indicate he had performed tests that might have saved my father-in-law's life if they actually had been performed. e His daughter (a nurse and lawyer) saw the unaltered records, but unfortunately by the time she saw that the records were later altered my father-in-law was mentally incompetent to execute an affidavit that the tests in the record were never performed - so they got away with it.
But my father-in-law was relatively wealthy, had insurance, and still had a crappy incompetent doctor. His doctor didn't abandon him - but he might as well have.
It isn't clear to me that your dad's problems were related to Medicare so much as they were to a crappy doctor. (For starters, I don't see anything that suggests that it was Medicare issues that made the first doctor abandon him.)
Glitterati
(3,182 posts)The problem, however, was that each of these doctors were "assigned" to my husband by the hospital.
Because they were the only doctors who took medicare.
Ms. Toad
(34,057 posts)but what you (if, heaven forbid it happens again) or anyone else similarly situated might do is to scour the community to find a doctor who accepts Medicare who had admitting rights at the hospital. It might have ended up being the same list - but hospitals are often lazy, or overwhelmed, or whatever the bureaucratic excuse of the day is, and fall back to a list that is limited or out of date or relies on a rotation of Medicare assignments, or only appoints the doctor on call for the day.
We weren't on Medicaid at the time, but we had a very restrictive insurance policy that left us in the cold with no surgeon for a procedure that had a very time-limited window (we were changing policies in a few months and most policies didn't even cover the surgery). We found a doc who accepted our insurance and had good recommendations (even though his qualifications were not, on paper, what we would have liked). He performed the surgery in a hospital with a staff he had never worked with before because that is where our insurance covered - and he had admitting privileges there (he couldn't have accepted our insurance if he hadn't had them). But the hospital never would have assigned him to us, since he wasn't even on their radar.
And - no - it shouldn't have to be that complex (and wouldn't be if we got single payer like we should have). But there are often ways to work the system (and because it is so complex, the need to work the system keeps a lot of people from getting the care they deserve - especially people who have fewer educational/personal/financial resources - but I have seen some very well situated people stymied by the system as well).
Glitterati
(3,182 posts)because when they threw him in the helicopter and life flighted him to a hospital with a massive MI, we didn't have time to Doctor shop. By the time WE arrived at the hospital, they already had him in surgery.
As for the admit when he had the infection, that, too was an ER admit. We were actually in Florida at Disneyworld when the infection finally caught up with him. We went from the airport at home to the ER. He was in critical condition with the MRSA infection the doctor had ignored for months.
Ms. Toad
(34,057 posts)From the little bit you had said, it sounded as if he didn't have a regular physician established. It definitely stinks that people have to limp along getting worse and worse when simple outpatient care could address the problem with far less cost and misery.
With any luck, once the ACA kicks in completely there will be fewer people forced to use the ER for healthcare, no matter how adequate Mitt Romney thinks it is...
(We've actually had really good luck with ER docs - they have turned out to be some of our favorite docs. But it has always amazed me when the pot luck specialist actually turns out to be decent.)
uppityperson
(115,677 posts)matt819
(10,749 posts)I'd be interested to know the statistics for doctors in private practice vs. those who work for large health care corporations.
In my area, there are, as far as I can figure, very few doctors in private practice, and, really, I don't know what their payment policies are. Most of the health care providers in this area are associate with a large regional non-profit system. This group is the network provider for many HMO and corporate systems and accepts private insurance, Medicare, Medicaid, etc. And, putting aside a complex discussion of medical costs and payments, this system is very happy to work with its patients to come up with payment plans. it's not perfect, but it works well enough.
I would bet that this is the case with many areas of the country.
Sure, there is a problem with the allocation of health care services to underserved areas, and maybe these areas have price practice doctors who don't process insurance and refuse Medicaid/Medicare, but, as I mentioned in my longer post, it's not their responsibility to correct inefficiencies in the market or other help fix the multi-trillion dollar health care industry.
You are clearly passionate on this subject, even if I think you are way wrong. My guess is that you or someone you know has a specific issue with a specific provider. Fair enough. But it's not reason to take such a violent and broad-brush approach to resolving the problem.
NotThisTime
(3,657 posts)Indian Reservation in Oklahoma.... He took it until the insurance companies took him right out of business
LadyHawkAZ
(6,199 posts)
If you want to make an effective threat, start the ball rolling on legislation allowing pharmacists to dispense medication like they do in other countries, since patient care is threatened by doctors refusing to accept insurance or Medicare (say that as loudly as possible in front of every available news camera)- and see if things don't change in a big hurry. And look! no one goes to jail! Isn't that nice?
Nikia
(11,411 posts)He is an older family physician who was sick of the insurance bs and just wanted to finish out his years practicing medicine. A number of his patients are the working poor who can't afford insurance but not qualify for Medicare.
The co pay for insurance from my previous employer was $30/office visit. The health care cost of family doctors in the major health care system that I see doctors with is over $100. I'd say that he is nicer to uninsured poor patients than that system. So you think he should be put in prison?
Blue Idaho
(5,045 posts)Does he have a staff of registered nurses? Does he own his building or rent? Does he carry enough insurance? Does he own all of the medical equipment, does he have any in-facility labs?
If he has no loans and is close enough to retirement perhaps he can limp through to the end of his career but I have to tell you - a GP can't cover their overhead on $30 office visits.
The guy may be a saint and he may be offering real value for his poorer patients but unless he's practicing medicine alone out of his car in an Walmart parking lot his monthly nut is way too big for $30 office visits.
Nikia
(11,411 posts)He has been in practice for decades but his no insurance thing is only a couple of years old so he might own his location and equipment outright. He does have an RN or two because he mentioned in an article that is his biggest expense. He is in his 60s so he probably will retire if and when his practice becomes much of a money drain.
There might be cash/payment only doctors though that charge a little more that also serve mainly people without insurance that can keep prices more reasonable than insurance acceptors by not having insurance specialists on staff. If they can stay in practice with this policy, I don't see why they should be penalized.
Blue Idaho
(5,045 posts)It's a free country - if a doctor thinks they can provide quality care at a more affordable cost - why not?
Comrade_McKenzie
(2,526 posts)
ZombieHorde
(29,047 posts)
Indpndnt
(2,391 posts)
You're joking, you have to be.
cr8tvlde
(1,185 posts)That's all they have to say. But I must admit, I've had better care...much better care...going to a Nurse Practitioner/Physician's Assistant...they tell the Doctor what to prescribe. The MD thing is a racket, for the most part. You don't need to go to someone with 12-15 years of school/internship for a rash or a cold or a headache or even to set a broken bone.
The MD in our family is paying back almost $2,000 a month of student loans and will not be making money until at least 5 years in "practice"...She's almost 30. They have to charge the outrageous fees to pay back their loans and begin to carry their own weight financially. And she makes less than her sister who is a Marketing Analyst for cookies and crackers at Kellog/Walmart. Reality Check.
Swede Atlanta
(3,596 posts)I am not going to support efforts to force doctors and other providers to accept Medicare or Medicaid. if we have a "private" health insurance program supported by a combination of private and public (Medicare/Medicaid) insurance programs we must allow providers to decide which programs they will support.
We must ensure that the public options reimburse providers If not the entire house of cards comes down.
The sister of a friend of mine recently moved into my area. She is having some health issues. She has been working on finding a specialist that accepts Medicare for 4 months!!! This cannot be the future. If it is, we are screwed.
Honeycombe8
(37,648 posts)I remember hearing stories decades ago about how hard it was to find a dr who would take Medicare. Finding a dr who would take Medicaid was out of the question.
Any time you pay a lesser fee for services, a dr with a good practice won't take that insurance. Why would he replace a high-paying patient with a low-paying one?
So the drs you get under Medicare are not the best, and they are few and far between. You get doctors who don't have a robust practice, or are new.
I'm speaking of those in smaller cities, where I'm from. It might be different in big cities.
Blue Idaho
(5,045 posts)Does he offer deep discounts for cash? If he doesn't don't worry, he won't be in business long.
He's not practicing medicine - he's practicing financial suicide.
Ghost in the Machine
(14,912 posts)area DEPEND on Medicare, and the State equivilent (Tenn-Care) because there are sooo many people on it! I live in the 4th smallest, and one of the poorest, counties in Tennessee. We *finally* got a very good Orthopedic Doc in the next town over... and he takes Medicare. Before he set up shop, we had to travel 60+ miles, either way to Chattanooga or Knoxville, for an Ortho. My Neurosurgeon is in Knoxville.. I just made the 140 mile round trip to see him Thursday... after making the same trip a week before for my yearly MRI check-up on my neck.
Just my opinion, and reallly a fact in my particular area, for every doctor who *doesn't* take Medicare, there are 20 who will...
Peace,
Ghost
Zalatix
(8,994 posts)Ghost in the Machine
(14,912 posts)
Tell his sister to move a little farther north to Tennessee?? Tell her to try around Emory University Hospital (I'm assuming they're in Atlanta due to his user name)? It's a teaching hospital, like UT Medical Center in Knoxville, and is staffed by school faculty.
Emory University Hospital, one of "America's Best Hospitals," specializes in the care of the acutely ill adult.
Staffed exclusively by School of Medicine faculty who also are members of The Emory Clinic, the hospital is renowned as one of the nation's leaders in cardiology and cardiac surgery, oncology, transplantation and the neurosciences.
Our core purpose: To Serve Humanity by Improving Health through integration of education, discovery and health care.
Call 404-712-2000 for information.
Contact InformationOperator: 404-712-2000
Patient Information: 404-712-3411
HealthConnection℠: 404-778-7777
Physician Referral Line: 404-778-5050
Guest & Volunteer Services: 404-712-0375
Human Resources: 404-686-7100
Public Safety: 404-712-5598
http://www.emoryhealthcare.org/emory-university-hospital-atlanta/index.html
Do you have any ideas?
porphyrian
(18,530 posts)Indykatie
(3,695 posts)Doctors participate in insurance networks because large insurance carriers pay them directly for the care. Most see this as preferable to having to chase down patients for their bills. I am most familiar with the Anthem/Wellpoint networks who have more than 90% of doctors contracted in their network and 98% of hospitals. Walking away from this direct stream of income would not be a good business decision since few individuals can afford to pay for their care out of pocket and then wait for reimbursement from the insurance company. Patients would simply find another doctor that is in the network. If a doctor wants to opt out of the system I say let him/her. That's a business decision that they should be free to make without threat of reprisal. I believe the number that will do this is not as big as some think. Also too as Palin would say most primary care practices are now owned by large hospital systems who are making the contracting decisions for the doctors and they have a vested interest to participate in insurance networks and to accept Medicare which represents a sizeable portion of their income.
moriah
(8,311 posts)I had insurance, they did not take any insurance whatsoever and charged a ton. Hence, they had plenty of openings.
The person who referred me? The psychiatrist at the hospital I was receiving outpatient therapy with, under insurance.
-------
Yes, my insurance could have reimbursed me the money. But I didn't have the money and it would have taken a long time to get the reimbursement back. Hence, I waited until a doctor did have an opening and stayed longer in their outpatient program for medication management.
If the doctor was willing to go through the process of filing his billings himself and accepting the negotiated rates, he probably would have had more clients. But what he had were clients, instead, who could afford to get rushed in. I couldn't.
Yes, this is a problem. I wouldn't say yank their licenses, but maybe create a tax penalty? It made it where the cost of my care cost my private insurance more since I stayed in-network -- as I had no other choice. And I wasn't below the poverty line by any stretch, nor part of Romney's "47%".
Incitatus
(5,317 posts)Lowering their payments isn't going to encourage them to go into primary care instead of a specialty where the financial benefits are much higher. If we offered to pay the full educational cost doctors who were willing to work primary care for x amount of patients or x amount of years, that might be a viable solution .
Chan790
(20,176 posts)Cash or check only, willing to finance at low-or-no interest. (I'd probably accept Medicare/Medicaid.) For the same reason my general practitioner does not accept insurance (and I opt to not carry anything except major medical to account for things like broken-legs and cancer), because the standards-of-care and the payment-schedule imposed by most insurers are awful.
Because my doctor does not accept insurance: my visits are reasonably-priced, my lab-work is reasonably-priced, the pharmacist he works with is reasonably priced, and on and on and on.
This week I had bronchitis...my total out-of-pocket cost with scripts: $122. If I had insurance, the copays would have been higher than that, less money than that ends up in the doctor's and pharmacist's pocket, the insurance company would have billed higher than that. Refusing insurance keeps costs down. Refusing insurance increases the ability of practitioners to serve the poor or to work out ways to be paid. Refusing insurance keeps medical costs reasonable.
While I see your point, you're jousting at the wrong windmill. If the compensation to the service-provider were fair, the process to file simple and the benefit to the consumer equal or better; I have no doubt that my GP would take insurance if for no other reason than billing-ease. Absent serious healthcare-reform, no doctor should accept insurance. It's bad for patients and for doctors.
meaculpa2011
(918 posts)She charged me $145 for my last annual visit and it was a complete physical exam. I live in NYS so I cannot have only Major Medical (I can but it costs the same as comprehensive). When my kids go in for a routine exam I get an explanation of benefits statement from my insurer. Their costs are double for a cursory ten minute once over. It's the bureaucracy and the compliance that jack up the costs.
We have a mishmosh of ill-conceived and wasteful third party payment systems and the ACA did nothing but enshrine all the worst aspects of it.
Flame away, but that's the way I see it.
dionysus
(26,467 posts)
also, while you could make a case for this idea, albeit a misguided one, for doctors who have a say in the matter. ie. doctors who operate their own private practice, doctors who work in clinic settings have no control over what insurance they accept; corporate does.
Auntie Bush
(17,528 posts)He did this by closing down his whole practice and everyone had to reapply to get in by paying $1500 up front and have good insurance...no medicare patients!
He explained he was doing this to cut down on patients because he worked to hard and wanted to have more free time and "spend more time with his family" Bull! . He just wanted to get rid of all his Medicare and Welfare patients He dumped 2000 patients on the other Drs. in our small town and now they are ALL overworked and no one is accepting new patients. Many people have to travel almost 35 miles to find a Dr.
I don't know what people are going to do when ACA takes place and most everyone will have insurance. I guess charging $1500 in advance solves that problem. So now only the upper middle class will be able to have a Dr. More Drs. around the country are already doing this. Every time I go to the Drs. I get a different Dr....so now I no longer have my own Dr.
AS I said earlier...WE need More Doctors and more medical schools. We also don't need more foreign speaking Drs. to fill the shortage.
slackmaster
(60,567 posts)If you don't like something about a doctor, you can always choose a different one.
Glitterati
(3,182 posts)Sorry, but the list of doctors in my area who take Medicare OR Medicaid are zero. It's a 35 mile ride one way to the nearest doctor who will.
I'm in metro Atlanta, a bedroom community, 35 miles outside the city.
Phentex
(16,334 posts)I can't read the full stories because I am not a subscriber but I saw one of the articles last night after I had been reading this thread.
"More Georgia doctors limit Medicare as senior population swells" plus two more on doctor shortages.
That's not why I believe it. I have seen it first hand myself.
I get the sentiment of the OP. I really do. And I see a problem. However, as many have pointed out, the answer is not to yank licenses or jail doctors. The answer comes closer to post 97. There have to be real changes made. This does NOT equate to letting people suffer!! Nobody wants that. I am sure if we could wave our magic wands, we'd have FREE health care for all.
But realities must be faced. You can't get blood from a stone. There is no quick and easy fix but the OP is not being very realistic. And it's simply wrong to get mad and accuse of others of not caring.
Zalatix
(8,994 posts)If you're cosigning onto that, then your point is rational, too.
Glitterati
(3,182 posts)And, as the OP said, OK, the jail thing is a bit extreme.
But, frankly, the medical profession killed my father. I stood by, helplessly, and watched it happen.
There HAS to be a better way.
clydefrand
(4,325 posts)Who will the Romney's (ie. 1%ers) doctors then? (they don't seem to really believe in insurance for anyone else)
Xipe Totec
(43,889 posts)Forcing the doctors to accept patients when Medicare does not cover the cost of treatment is a recipe for disaster.
Why not force doctors to treat them for free? Why pretend to pay them fair wages?
What you are proposing is called slavery, my friend.
bluestate10
(10,942 posts)We can't expect people that come out of school with half million dollar debts and then have to rent expensive equipment, pay high malpractice insurance rates, pay for medical assistants and office staff to work for $35 per patient. I have been in a doctor's office, this may get me torched, but older people require more of the doctor's time than younger people like me. A doctor has me in and out in 15-20 minutes, and my rate is higher because I have private insurance.
Xipe Totec
(43,889 posts)On one side, my brother in law, a neurologist, who sees primarily elderly patients. Old people have more neurological problems? Go figure.
On the other side, my elderly mother, suffering from advanced Parkinson's disease, having her benefits cut in the interest of "cracking down on waste and abuse". She suffers dementia, has been declared mentally incompetent, my sister is her guardian. Yet, a social worker comes and, without consulting with my sister, interviews my mother about her ability to care for herself. Naturally, my mother puts up a stoic front and says: "Of course I can take care of myself..." So based on that interview, they cut her benefits and she no longer has the nurse to look after herself...
Should the nurse be forced to take care of my mother for free or be arrested for dereliction of duty?
I don't think so.
This crackdown on fraud and abuse is having repercussions on our vulnerable elderly.
markpkessinger
(8,392 posts)... I'm pretty sure you have to pass laws making it illegal for a doctor to refuse to accept them first.
Fla_Democrat
(2,547 posts)that is only seeing me to avoid prison, but hey, that's me.
HockeyMom
(14,337 posts)Collect from your insurance company yourself. That is what I learned many years ago. PPO? Oh, that is fine. Medicare? I have been in doctor offcies where Medicare patients have had to shell out their OWN MONEY and then try to get reimbured from Medicare themselves.
Been there, done that. You are better off with NO INSURANCE at all than an HMO, and probaby Medicare too. No insurance? Sick? No money to pay? I have been to a clinic with no insurance, no jobs, and they charged TEN DOLLARS for the office visit and gave us FREE meds.
Having insurance seems to be WORSE.
Response to Zalatix (Original post)
Pacafishmate This message was self-deleted by its author.
