The United States have higher health care costs than any other advanced country, whether measured on a per capita basis, as a percentage of the economy, or in total dollars spent. The high cost of health care in America has been largely affected by the current financial crisis, and public insurance programs are also being hit. State and federal governments are straining to meet the rising costs of Medicaid and Medicare. Many states are having to decrease funding in other areas, such as education, to meet elevated Medicare costs. For physicians, especially, Medicare has become a burden more than a blessing. It is a source of frustration that at times prohibits physicians from doing the jobs they set out to do, in the name of regulation and money. Currently one in seven Americans are covered by Medicare. For the physicians who treat these people, Medicare may become a barrier to proper treatment.
Under Medicare Part B, physicians are only reimbursed for procedures that are considered to be reasonable and necessary. Physicians are not compensated for talking to patients, but rather for the procedures they complete and for the number of patients they see. Physicians are often criticized for not spending enough time with their patients and for not providing informed medical care with empathy and effectiveness. However, it is Medicare that dictates how many patients that physicians must see in order to meet the reimbursement quota, and therefore how much time they can spend with each patient. Overhead practice expenses, including rent, nurses’ salaries, and malpractice insurance, have become so high that physicians must see more patients in order to be able to pay for all of the other costs associated with practicing. The physicians who do not own expensive equipment, such as MRI machines, which are much more lucrative as far as Medicare reimbursements than office visits, are forced to see fewer patients in more time in order to keep up with their overhead. Dr. Michael Stewart, chairman of the department of otorhinolaryngology at New York-Presbyterian Weill Cornell Medical Center, said that the challenge today is that “everything is going up except reimbursement. The tendency is to see more patients in a given amount of time, and so less time is spent with each patient.”
Although each fee paid by Medicare to physicians is meant to reimburse them for the time and skill they put into each service to each patient, the reality of the system seems to have become almost the opposite. Many physicians believe they cannot fully perform their jobs and desire to have more face-to-face time with their patients. They are frustrated that they are unable to do so because regulations deny them the ability to do something that automatically should be done.
The future of medicine will depend on how the Medicare system adapts and evolves with the realities of health care today. Dr. Byron M. Thomashow, medical director of the Center for Chest Diseases at New York-Presbyterian Columbia Medical Center, said, “We need to go forward with something that keeps the humanity in medicine.” I agree.
http://www.nytimes.com/2008/07/24/opinion/24bach.html
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4 comments:
I completely agree. I have actually noticed that my doctors here in Chicago appear to be anxious to fly out of the door, less willing to discuss any medical concerns, and overall less sympathetic to my desire to fully understand and discuss everything with them. It could just be because I am a sciency person that I like to understand more about my prescriptions than the average person, but I still believe that there should be more emphasis on developing relationships with patients.
Hmmm...surprise surprise that doctors are better able to care for patients without government mandated standards of care and quotas. I’m not trying to imply that government is anything less then well-meaning, it’s just that the only way to ration finite healthcare dollars (medicare B) is to use them in the most cost-effective way possible – by requiring that doctors see more patients.
Just to add, universal healthcare is often touted as a cure-all for problems in the medical system and access to healthcare, but its not a stretch to see that the problems of medicare would be magnified in a single payer system that covered everyone in the U.S.
Erin M.
Keep an eye on the new administration in the White House. It is a very interesting decision to create an Office of Health Reform as the president-elect has chosen to do. His idea is to look at the possibility of running national health care on the same model as the federal reserve banking system. Could mean some BIG changes in priorities and better payment for the caring part of health care. ... maybe not, but maybe so .. at least we have someone at the top willing to take a crack at it.
Optimistically yours, PJM
Well, I understand the position of the article. First, the govenemnt does not pay the doctors the amount their billers tend to bill for. e.g., A physcian may charge $100.00 and may only receive a check for $28.00. Is that fair maybe not but most billers may charge a higher fee just to get paid. Also, the governemnt is not the only insurance company/ carrier that does not pay the physcian well. This is across the board. It depends on the physcian and on how much time they spend with their patients. The government may suggest guidelines but no one in truly in the physcians office everyday trying to determine if the doc. spent 30min. with the patient. This is determine by the physcian and the staff. The physcian staff should schedule appointments that will allow the patient to have an informed visit. Therfore, the amount of money made in the profession of medicine is not the same as it was in it's hay day. What is essential is the passion of the physcian. I believe the amount of money made should not influence the amount of time a physcian spends with their patient. Rather it is truly about the organization, efficney, and customer service that plays a major role in the sustainability of an office.
KIRK
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