A headline like this makes one wonder what “Medicare for All” would look like, or what effect President Obama’s proposed “public plan” would have on physicians. It illustrates again that having medical “coverage” is not the same as getting the medical are you want. Some excerpts from the New York Times article:
Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle. …
In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 28 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before. And a 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did. …
Other options are also available. Roughly 18,000 walk-in, stand-alone urgent care centers in the United States are staffed with doctors who set simple fractures, take X-rays, do minor surgery, diagnose ailments and write prescriptions. By far the majority of these centers take Medicare.
Although they were never intended to provide continuing care, “our primary care practice is growing more than anything else,” said Dr. Franz Ritucci, who is medical director of the American Academy of Urgent Care Medicine and practices at America’s Urgent Care in Orlando, Fla., a chain of walk-in centers that also has clinics in Columbus, Ohio. …
Another, more expensive option is concierge or “boutique” care, which comes in two forms. In the most popular kind, doctors accept Medicare and other insurance, but charge patients an annual retainer of $1,600 to $1,800 to get in the door and receive services not covered by Medicare, like annual physicals. Before signing up and paying the retainer, patients should get a written agreement spelling out which services the doctor will bill Medicare for and which the retainer covers. And always check carefully for double-billing.
The other form of concierge medicine — doctors who have opted out of Medicare — is more expensive still. Fees range as high as $15,000 a year and cover office visits, access to the doctor when care is needed, referrals to specialists and thorough annual physicals.
Dr. Knope, the author of “Concierge Medicine: A New System to Get the Best Healthcare,” has this kind of practice in Tucson. His patients sign a contract agreeing to pay $6,000 a year for individuals and $10,000 a year for couples. The fee covers office visits, physical exams and phone consultations, and Dr. Knope will meet patients in the emergency room, see them in the hospital and occasionally make house calls.
A list of about 500 concierge doctors throughout the country is available on Dr. Knope’s Web site, www.conciergemedicinemd.com.
(via FIRM)
