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Primary Care Doctors And The Medicare Boycott

I saw this interesting article linked to from a blog about angry doctors dropping out of Medicare in Texas. As one who shares the universal annoyance at congress’ failure to fix the SGR for more than 30 days at a time, I was kind of cheered by this. That’s what it will take to get the system fixed — a grassroots, full-scale rejection of the system! Good for them. And the opening lines of the article were encouraging:

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

An “alarming” rate. Wow. Cool. So how many is that, anyway?

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

That’s 300, right? Hmm, not too shabby. Not exactly going to topple the state with that, but it’s a start.

Hey, I wonder how many doctors there are in Texas, anyway? I hear it’s a pretty big state, though I seem to recall it consists mostly of scrubland and swamp. Maybe there are only like 500 doctors in the state to start with. Something is tickling my head about Texas, though, I vaguely remember that they had some nice tort reform law a few years ago that I was pretty envious of. Read more »

*This blog post was originally published at Movin' Meat*

Doc Fix Blamed On Doctors

The American Medical Association will launch a multi-million-dollar ad campaign tomorrow to heighten pressure on Congress for a doc-fix bill. The American College of Physicians (ACP) reacted by calling for doctors to contact their member of Congress directly to let their voices be heard. Robert Centor, FACP, called for doctors to protest as well. (American Medical Association, American College of Physicians, DB’s Rants)

Meanwhile, a Florida medical society predicts a crisis in that senior-laden state. The society cited but did not name eight primary care doctors who’ve stopped accepting Medicare patients this year, and 12 cardiologists who left private practice for employment elsewhere because of already reduced payments. Unbelievably, business columnist Steven Pearlstein sorted through the issues around the doc fix, and concluded that it’s the docs that need fixing for paying themselves generous salaries. (Naples News, The Washington Post) Read more »

*This blog post was originally published at ACP Internist*

Medicare Cut Effective Today: Who Should Doctors Be Angry At?

Instead of blogging (again) about Congress’s failure to stop the 21% Medicare SGR cut, which went into effect today, I could just re-run my April 16 post. I wrote then:

“It is the failure of both political parties, over many years, to honestly deal with the SGR, including the cost of getting rid of it, which has resulted in the current ongoing SGR farce. And yet members of Congress wonder why the public holds them in such low regard.”

Blogging in DB’s Medicare Rants, Dr. Bob Centor captures the outrage felt by most physicians:

“I am mad. Every physician I know is mad. Patients should join us in expressing anger. Physicians cannot trust Congress if they cannot repair this absurdity.”

(Bob references ACP’s statement, released on Friday; click here to read it in its entirety.)

That Congress allowed politics again to get in the way of doing what is best for patients makes my blood boil. Voters can and should hold them accountable. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Will Large Employers Dump Healthcare Coverage?

Fortune magazine has made some news recently about the impact of healthcare reform on large employers:

Internal documents recently reviewed by Fortune, originally requested by Congress, show what the bill’s critics predicted, and what its champions dreaded: many large companies are examining a course that was heretofore unthinkable, dumping the healthcare coverage they provide to their workers in exchange for paying penalty fees to the government.

The only trouble? There’s no way these employers are seriously thinking about doing this.

I can understand why the employers would do the math. According to healthcare reform law, penalties for failing to provide health coverage are a small fraction of the cost of that coverage. But as with most everything else in healthcare, there’s much more to it than just a simple math equation. Here’s what I mean. Read more »

*This blog post was originally published at See First Blog*

How Will The Medicare Cut Affect You?

Once again, Congress is playing with fire by not enacting a permanent solution to the Medicare SGR (sustainable growth rate) physician payment cut problem.

Congress got itself tied up in knots trying to figure out a way to reverse a 21% cut in Medicare payments to doctors that went into effect yesterday. It ended up agreeing to legislation, which was signed into law late Thursday evening by President Obama, to restore payments to the pre-cut (2009) levels through the end of May.

The action, though, may have come a dollar short and day late. CMS has indicated that it had no choice but to tell carriers to begin processing claims with the 21% cut, starting yesterday. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

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