Tuesday, August 7, 2007

Dr. Kevin Pho on Medicare

Dr. Kevin Pho, who runs the outstanding KevinMD.com blog, has written the following OpEd on Medicare cuts and the impact on doctors. Here are some excerpts:
Medical practices today essentially function as small businesses. Physicians are responsible for expenses like rent, payroll, employee health insurance and malpractice insurance. These costs are expected to increase 20 percent in the next nine years. During this same time, physician Medicare payments are faced with cuts of 40 percent. Already, some practices lose money every time a Medicare patient is seen. Some may find the link between medicine and money distasteful, but the hard truth is that it is impossible to practice medicine in a business model that is headed for financial disaster.

At a time when baby boomers are approaching the age of 65, some physicians attuned to this economic reality have simply stopped accepting Medicare patients. According to a recent survey by the American Medical Association, 60 percent reported that they would have to limit the number of new Medicare patients they treat due to next year's cut. Half would reduce their staff. Fourteen percent would "completely get out of patient care." Some seniors are already faced with calling 20 to 30 providers in the desperate hope that someone will accept Medicare.
As David Catron points out:
...[F]or Medicare patients, there is already a shortage of primary care physicians. For all of you out there clamoring for "single-payer health care," this shortage is a taste of what you will face under such a system.

Medicare is, for all intents and purposes, "single-payer for seniors." Indeed, "Medicare for all" is the battle cry of many single-payer advocates. Well, the system they want for everyone is already vitiating the care of seniors.

Advocates of government-run health care often admonish us not to conflate "single-payer health care" with socialized medicine. For the patient who cannot find a primary care doctor, this is a distinction without a difference.