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Politics : Formerly About Advanced Micro Devices -- Ignore unavailable to you. Want to Upgrade?

To: Bilow who wrote (703233)	3/8/2013 12:54:03 PM
From: i-node	Respond to of 1576252

There are a couple of things going on -- Medicare and Medicaid are expanding, and they're both reducing what they pay physicians as government plans continue toward the eventual end -- going flat broke. Some doctors -- and this could be the situation with your mom's -- are backing out of Medicare and Medicaid, or just moving toward cash only. I've had several physician customers who have just backed out of insurance altogether and accept only cash accounts. For example, one internist just switched to doing botox & other cosmetic procedures. Another files a small amount of commercial insurance for selected patients but has moved toward doing commercial services such as drug screens as well as cosmetic. My daughter is a highly specialized behavior analyst/speech pathologist who works exclusively with autistic children. When she started her practice a few years ago, I encouraged her to file claims as an accommodation but never to go "in-network" with any insurance company. Her patients pay the full toll unless their insurance will pay out-of-network providers; it does mean that she only has kids who come from families with money, but it also leaves her with time to train other speech pathologists on her techniques, which allows THEM to service the clientele with Medicaid. She can collect a multiple of what Medicaid would pay but still enable others to serve those markets. It just doesn't make financial sense to get involved with government programs today and ultimately, the best providers are not going to be available to those who are on Medicare and Medicaid. But these transitions take years because most providers are not willing to walk away from their MC/MA patients even if they lose money on them. Slow, but the speed with which this transition is occurring is alarming. When you have 1 in 3 primary care providers refusing new Medicare patients, that is a very big development.

To: Bilow who wrote (703233)	3/8/2013 2:39:16 PM
From: bentway	Read Replies (1) \| Respond to of 1576252

"He said that he didn't like having to see an excessively large number of patients. I don't know if this is related to medicare; my guess is it isn't." Insurance companies set the time a doctor can spend with any one patient. Ask your doctor. The Doctor Will See You-If You're Quick thedailybeast.com "At least part of the blame began with the managed-care revolution of the 1980s and ’90s, an initially well-meaning effort intended to improve the quality of medicine and control costs, but which ended up fracturing the doctor-patient bond. Many insurers focused more on cost at the expense of quality. They negotiated lower and lower fees for doctors, who slashed the time spent with patients to fit more of them into a day. Despite the accelerated schedule, this has meant a decline in income for most physicians over the last decades, with primary-care doctors hit hardest. A 2006 report found that inflation-adjusted incomes for all doctors decreased by 7 percent from 1995 to 2003, and by 10 percent for primary-care physicians."