Medicare as a window into the failure of socialized health

Topics: Health
29 Nov 2007

From: Ervan Darnell



From "Smart Money" [1] (not a partisan source):
[Primary care doctors are in short supply] The income of primary-care doctors is under such pressure these days because general practitioners are paid roughly $30 to $70 for each patient they see regardless of how long the individual visit. That scale, based on Medicare reimbursements, has changed little since 2000.
Government price fixing creates a shortage. Wait until they apply it to it all specialties. In fairness, insurance is complicit here too as they negotiate primary care doctors down to the bone and consumers aren't willing to pay extra (which is again the government's fault for the tax code bubble that transfers health insurance to your employer).
Personally, I pay out of pocket for my primary care physician (he won't even take insurance), just to avoid these problems and his possible conflict of interest in serving the insurance company. I fear that Hillary will outlaw this, or regulate into not being affordable somehow.

"If you're over 65, don't bother me..."
As troubling as things are in primary care, the situation is worse when it comes to treating elderly patients, especially those on Medicare. [....]
The problem is that fewer medical students are choosing this subspecialty: Last year only two-thirds of geriatric fellowship programs were filled. That's because treating older patients who have multiple, often complex problems is about the worst way a doctor can make a living. Medicare doesn't compensate much more for a 45-minute appointment with a patient with dementia, hearing loss and a half-dozen other maladies than it does for seeing someone for a simple checkup. "It is fiscal suicide to go out there and say, 'I am a geriatrician,'" Robinson says. "You get the patients that require the most time that pay the worst."
In other words, even though Medicare is the most expensive (or soon to be) budget item for the federal government, and it's too little anyway. Its cost structure is simply to de facto deny care by creating a shortage of appropriate physicians, exactly what Canada is doing, letting people die in line.

http://www.smartmoney.com/10things/index.cfm?story=december2007&afl=myyahoo&pgnum=1
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Ervan Darnell
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Subject: [Ragnar] Gwen Ifil on Scott Brown
From: Ervan Darnell
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I have respect for "The Newshour" as a reputable and neutral source,
but the reporting Wednesday made me pause:

> [Brown's election] instantly casts a cloud over the future of health care reform legislation. [1]

This is already presumptive that it is "reform" just because it calls
itself that, and the phrase "casts a cloud" is suggestive this is a
bad outcome. Yes, there is a neutral reading if you stick strictly to
the grammar, but my thought was it could have just as well been
phrased:

'[Brown's election] instantly creates a ray of light for stopping more
government control of health care.'

You'd never hear that from the MSM, likely not even Fox.

----
[1] http://www.pbs.org/newshour/bb/politics/jan-june10/massachusetts1_01-20.html

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