Sandra Duck thinks she’s the victim of an undeclared Medicaid boycott. And she’s probably right.
When her artificial right hip became infected with the superbug MRSA in late 2009, Dr. Dale Mitchum, a general surgeon, drained, cleaned and closed the infected area. But when the infection returned in early 2010, Mitchum knew Duck needed another hip replacement surgery, which he couldn’t perform. He tried to find an orthopedic surgeon who would operate. More than a year later, he’s still trying.
“I cannot find a living soul that will touch her,” he said recently. “And I’ve tried everywhere, from Tallahassee to Pensacola.”
All too true. Many doctors, etc. don’t take new patients using Medicaid and assuming they see a doctor, they can’t always get their meds quickly. Our state pays an out of state company to run the computerized Medicaid program used by pharmacies to verify coverage. Trouble is, the paperwork on income/eligibility for Medicaid has to be done every month, so those names have to be entered in the system every month and it never fails, come the first of the month there are always people whose paperwork hasn’t been done or who haven’t been added to the system yet. It takes at least 3 days to update them in the system, sometimes a week. My pharmacy used to give people the meds and charge the system later, but they refused to cover meds given while the paperwork wasn’t done and we can’t give ’em away for free… Now they say the number of people on Medicaid could double, so, no doctors and no drugs the first week/10 days of each month will become the norm for many more people.
Interesting that only now does the press begin to grasp that just because you give someone a card that says “insurance”, doesn’t mean that it will actually purchase the healthcare product intended. I could decide tomorrow to print off “grocery” cards promising to pay grocers 50 cents on the dollar and then tell my constituents that I had solved the hunger problem, but we all know it wouldn’t “spend”.
A centerpiece of Obamacare was to shift privately insured patients into Medicaid. The problem is, that the private sector simply cannot afford to provide the service at Medicaid rates. This is a big reason why private medical offices are selling to hospitals in increasing numbers. The offices that don’t sell, will eventually have to go “concierge”.
My office basically makes all its profit on insured patients. It breaks even on Medicare and looses money on Medicaid. If even a small fraction of our insured patients change to Medicaid or even Medicare, we go out of business.
The public does not realize how close the system is to a meltdown. The only way my office can continue to see Medicare/Medicaid patients in the face of persistently rising overhead and falling reimbursement (from all the insurance carriers) is to either go concierge (no more Medicare/Medicaid at all) or be bought by a hospital. Hospital owned practices are allowed to charge more, so that will buy us a few more years in practice.
The public likes to imagine that the answer is to simply cut doctor’s salaries. After all, everyone knows a doctor who drives a BMW and has a beach house, right? However, several recent analyses have pointed out that doctor’s salaries make up only a small percentage of health care costs. The link below says 8%. If all doctors began to work for free, that would offset 1-2 years of healthcare inflation at best.
http://www.jacksonhealthcare.com/media-room/news/md-salaries-as-percent-of-costs.aspx
Personally, I would prefer that various entities, such as foundations, cities, states and in some cases the Federal Gov’t hire a physician to oversee a cadre of PA’s, NP’s and nurses to operate indigent clinics across the nation. We could possibly create regional government hospitals for the poor as well. I think we could bypass an awful lot of waste, outright fraud and unreasonable patient expectations, etc. with this system. As it is, costs will explode while service continues to deteriorate.
What a shame that the government prefers to take the wrecking ball to the system, while promising to “rebuild” it, Washington style. Good luck with that!
Do you mean indigent clinics and public hospitals like those that already exist in most major metropolitan areas? And which existed in many rural communities prior to medicare? I had the unfortunate experience 20 tests ago of listening to honchos in two smaller cities disavow their mission to serve the indigent. I’m not burnt on their situations, but last I heard they still collected tax money.
honchos in public hospitals in two smaller cities… And I’m not CURRENT on their situations.
We are seeing the meltdown of the entire medical system. Not just Medicare or Medicaid, but the private insurance companies will have to raise their premiums two to four times the present level to comply with the mandates for the policy in Obamacare. So businesses and individuals will not be able to afford it. They all will just pay the fine and go bare. They will end up in emergency rooms for “free” care until the hospitals go under. The wave hits next year in all it’s fury. Blue cross in our state just cut doctors pay by 25% and funnel all big procedures into five hospitals. The only choice is for doctors and hospitals to leave the preferred provider list so they can charge their usual fee and the patients will then have to collect probably about fifty percent to none for the service. Medicaid is going to a HMO format which none of us can do and survive. It is not just the low fees but the hassel factor. My office manager spent two hours yesterday just to get an approval for us to treat the patient.
Several years ago, several of us doctors got together to form a free clinic for the unemployed and poor. Our church was going to provide space. We would each work one or two days for free there. Our insurance liability carrier went ballistic. They said we could not be insured because this would be a great opportunity for the poor to get big bucks by lawsuits Our church stood to loose all the property and we would be bankrupt. So we didn’t do it. Hope the voting public enjoys the great change they voted for.