Office-based practices are focusing increasingly on patients 45 and older, reports the Centers for Disease Control and Prevention.
In 2008, those 45 and older accounted for 57 percent of all office visits, compared to 49 percent in 1998. Prescriptions, scans and time spent with the doctor also became increasingly concentrated on those middle aged and older, according to data from the CDC’s National Center for Health Statistics.
Also, physician visits increasingly concentrated on medical and surgical specialists and less on care provided by primary care practitioners for those ages 45 and older. Furthermore, for patients ages 65 and older, the percentage of visits to primary care specialists decreased from 62 percent to 45 percent from 1978 to 2008, while the percentage of visits to physicians with a medical or surgical specialty increased from 37 percent to 55 percent. Read more »
*This blog post was originally published at ACP Internist*
Some thoughts to chew on from Grace-Marie Turner:
But expanding SCHIP to cover all children would be a mistake, for four reasons:
1. First, Congress should make sure poorer, uninsured children are covered first. At least two-thirds of uninsured children already are eligible for SCHIP or Medicaid but aren’t enrolled. If SCHIP were expanded to cover children in higher-income families, their parents would rush to the head of the line to get the taxpayer-subsidized coverage. When a “free” government plan is offered, it’s nearly impossible to resist. Poorer children would be left behind as states focus on enrolling higher-income kids.
2. Second, expanding the program would “crowd out” the private insurance many higher-income kids already have. Hawaii offers proof. Earlier this year, the state created a new taxpayer-financed program to fill the gap between private and public insurance in an effort to provide universal coverage for children. But state officials found families were dropping private coverage to enroll their children in the government plan. When Gov. Linda Lingle saw the data, she pulled the plug on funding. With Hawaii facing budget shortfalls, she said it was unwise to spend public money to replace private coverage children already had.
3. Third, putting many millions of children on a government program will quickly lead to restrictions on access to care. A young boy died in Baltimore not long ago from an untreated tooth infection, even though he was enrolled in SCHIP. Few dentists can afford to take SCHIP patients because the program’s reimbursement rates are so low. The boy’s mother couldn’t find a dentist to see him. In Massachusetts’ move toward universal health coverage, more people have insurance, but they are finding that physicians’ practices are often filled, with waiting lists for a new patient appointment at 100 days and counting. Putting more children on SCHIP will add to the program’s financial pressures, making it harder for poorer kids to get care.
4. Finally, government insurance means that politicians and bureaucrats, not parents, make decisions about the care children receive and about what services will or will not be covered.