...Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors -- often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists -- are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors' reasons: reimbursement rates are too low and paperwork too much of a hassle.In contrast, both patients and physicians win with private "concierge medicine":
...Dr. Knope, the author of "Concierge Medicine: A New System to Get the Best Healthcare," has this kind of practice in Tucson. His patients sign a contract agreeing to pay $6,000 a year for individuals and $10,000 a year for couples. The fee covers office visits, physical exams and phone consultations, and Dr. Knope will meet patients in the emergency room, see them in the hospital and occasionally make house calls.This is the benefit when patients and physicians are allowed to contract freely for their mutual self-interest.
A list of about 500 concierge doctors throughout the country is available on Dr. Knope's Web site, www.conciergemedicinemd.com.
Is the care worth the money? Harold and Margret Thomas, who are in their mid-70s and live in Cincinnati, spend the winter in Tucson. After many phone calls, the couple were unable to find an internist in Tucson who took new Medicare patients, so they signed with Dr. Knope in 1996. Five years ago, when Mrs. Thomas developed a blinding headache, her husband called the doctor at 8 o'clock one night, and he, suspecting an aneurysm, insisted they get to the emergency room immediately.
The doctor met them and ordered an M.R.I. and a CT scan. The tests revealed an aneurysm, and Dr. Knope found a surgeon who quickly operated. Medicare paid for the emergency room, the surgery and the hospital stay.
"If there were a concierge practice in Cincinnati, I’d be part of it there, too," Harold Thomas said.