Well, well, well. The Left likes to claim that there will be no healthcare rationing in the abominable "let grandma die" ObamaCare. Oh really? How do they explain what's going on in the Mayo Clinic in Arizona? Are we expected to believe that this decision had nothing whatsoever to do with the Dems monstrosity of a plan which they have approved in both houses of Congress? You know, that plan to cut Medicare by nearly half a trillion dollars. I don't think so.
Read from Bloomberg:
Mayo Clinic in Arizona to Stop Treating Some Medicare Patients
By David Olmos
Dec. 31 (Bloomberg) -- "The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.
More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.
Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering 'the highest quality care at costs well below the national norm.' Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.
'Many physicians have said, "I simply cannot afford to keep taking care of Medicare patients,"' said Heim, a family doctor who practices in Laurinburg, North Carolina. 'If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.'
Medicare Loss
The Mayo organization had 3,700 staff physicians and scientists and treated 526,000 patients in 2008. It lost $840 million last year on Medicare, the government’s health program for the disabled and those 65 and older, Mayo spokeswoman Lynn Closway said.
Mayo’s hospital and four clinics in Arizona, including the Glendale facility, lost $120 million on Medicare patients last year, Yardley said. The program’s payments cover about 50 percent of the cost of treating elderly primary-care patients at the Glendale clinic, he said.
'We firmly believe that Medicare needs to be reformed,' Yardley said in a Dec. 23 e-mail. 'It has been true for many years that Medicare payments no longer reflect the increasing cost of providing services for patients.'
Mayo will assess the financial effect of the decision in Glendale to drop Medicare patients 'to see if it could have implications beyond Arizona,' he said.
Nationwide, doctors made about 20 percent less for treating Medicare patients than they did caring for privately insured patients in 2007, a payment gap that has remained stable during the last decade, according to a March report by the Medicare Payment Advisory Commission, a panel that advises Congress on Medicare issues. Congress last week postponed for two months a 21.5 percent cut in Medicare reimbursements for doctors.
National Participation
Medicare covered an estimated 45 million Americans at the end of 2008, according to the Centers for Medicare & Medicaid Services, the agency in charge of the programs. While 92 percent of U.S. family doctors participate in Medicare, only 73 percent of those are accepting new patients under the program, said Heim of the national physicians’ group, citing surveys by the Leawood, Kansas-based organization.
Greater access to primary care is a goal of the broad overhaul supported by Obama that would provide health insurance to about 31 million more Americans. More family doctors are needed to help reduce medical costs by encouraging prevention and early treatment, Obama said in a June 15 speech to the American Medical Association meeting in Chicago.
Reid Cherlin, a White House spokesman for health care, declined comment on Mayo’s decision to drop Medicare primary care patients at its Glendale clinic.
Medicare Costs
Mayo’s Medicare losses in Arizona may be worse than typical for doctors across the U.S., Heim said. Physician costs vary depending on business expenses such as office rent and payroll. 'It is very common that we hear that Medicare is below costs or barely covering costs,' Heim said.
Mayo will continue to accept Medicare as payment for laboratory services and specialist care such as cardiology and neurology, Yardley said.
Robert Berenson, a fellow at the Urban Institute’s Health Policy Center in Washington, D.C., said physicians’ claims of inadequate reimbursement are overstated. Rather, the program faces a lack of medical providers because not enough new doctors are becoming family doctors, internists and pediatricians who oversee patients’ primary care.
'Some primary care doctors don’t have to see Medicare patients because there is an unlimited demand for their services,' Berenson said. When patients with private insurance can be treated at 50 percent to 100 percent higher fees, 'then Medicare does indeed look like a poor payer,' he said.
Annual Costs
A Medicare patient who chooses to stay at Mayo’s Glendale clinic will pay about $1,500 a year for an annual physical and three other doctor visits, according to an October letter from the facility. Each patient also will be assessed a $250 annual administrative fee, according to the letter. Medicare patients at the Glendale clinic won’t be allowed to switch to a primary care doctor at another Mayo facility.
A few hundred of the clinic’s Medicare patients have decided to pay cash to continue seeing their primary care doctors, Yardley said. Mayo is helping other patients find new physicians who will accept Medicare.
'We’ve had many patients call us and express their unhappiness,' he said. 'It’s not been a pleasant experience.'
Mayo’s decision may herald similar moves by other Phoenix- area doctors who cite inadequate Medicare fees as a reason to curtail treatment of the elderly, said John Rivers, chief executive of the Phoenix-based Arizona Hospital and Healthcare Association.
'We’ve got doctors who are saying we are not going to deal with Medicare patients in the hospital' because they consider the fees too low, Rivers said. 'Or they are saying we are not going to take new ones in our practice.'"
Wow! Doctors are struggling with low Medicare payments currently. Wait until they get a little taste of ObamaCare. Oh, half a trillion less dollars for doctors to make ends meet. Are they nuts?
This article is an example of why I have renamed ObamaCare to the more accurately described "let grandma die" bill.
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6 comments:
When doctors truly have to worry about "making ends meet" then I'll become concerned about their wailing and gnashing of teeth,
Diogenes, do you really expect a doctor, who has invested a huge amount of time and resources in his/her education, to treat patients at a loss?
How about you turn in your teacher's salary and just volunteer to indoctrinate your students for free?
Again, let me know when doctors cannot "make ends meet".
As for the question "do I expect doctors to treat patients at a loss?" the answer is "sometimes, yes." Lawyers do a lot of pro bono (free) work for inidegnt clients; it's part of their responsibility to the rest of society.
And please notice, it's not the individual doctors that are doing this, it's the Mayo Clinic. And why? Because they're using their patients as pawns. They're hoping that enough patients wil be inconvenienced that they'll squawk enough to their elected representatives that something might change. It's a political game that hospitals have played ever since Medicare was started in the 1960s. When the Mayo Clinic consistently operates at a loss, let us know. (We won't hold our breath.)
As for turning in our teacher salaries, we just about do already. And it's either quite ignorant or quite insulting of you to even remotely compare the income levels of the average teacher with the average doctor.
Dear Diogenes:
Over three years ago my wife was diagnosed with late stage gynological cancer. She was in the operating room for 5 hours. The surgeon who operated on her at the Mayo Clinic in Rochester had 2 other surgeries for this cancer on the same day. The surgeon also performed similar surgeries on other days during the same week.
Mayo Clinic has specialists providing care for different types of cancer. I have no doubt that had we accepted the services of a surgeon locally that her prognosis would not have been as favorable.
Doctors at the non-profit Mayo Clinic are not paid fees for services, but are paid salaries, so there is no incentive to over-prescribe surgeries or other treatments. This contributes to the efficiency which Obama praised as the paragon of medical care.
No doubt my wife's surgeon earns several hundred thousand dollars a year. Despite its doctors being paid at the "market rate" for their high skill levels, further efficiencies at Mayo result from these specialists performing hundreds of operations a year, several times the number that of their colleagues who practice on a fee for services basis in more traditional practices. I know this from having had an operation at Mayo when it was explained that the surgeon at Mayo who performed the procedure on me performed the same procedure well over 300 times a year versus an average of under 50.
If the government decides to "improve" competition by expanding Medicare or by providing a different full-blown government option covering patients other than seniors, then for all intents and purposes the government run programs will become a monopsony having enormous buying power far beyond any insurance company. That will enable the government to dictate prices to the Mayo Clinic and the entire medical care industry.
Dear Diogenes:
With its monopsony power, the government will be able to, and have a strong political and fiscal incentive, to force costs down by imposing an expanded array of limits on medical care providers. True, it is possible today for the Mayo Clinic to close its doors to a fraction of the patients covered by Medicare, but there is a point at which a larger fraction of patients covered under any government run program will not allow health care providers to just say no. Translation: My wife's surgeon will become a defacto employee of the government run heathcare system, meaning that his salary will be dictated by government fiat. While he may still be able to "make ends meet" for his family, he may decide that the pace at which he works is not worth the effort as compared to his government dictated salary, or he may decide to retire or pursue a new career.
We have the best and the brightest attending our medical schools in this country for a good reason, the "market" still dictates what they will earn. I doubt very much that we will have the same bright students attending medical school after the government takes over a sizable share of the medical industry. It's simple economics... you get what you pay for. Lowering costs is one thing, driving earnings below a "market" rate of return sought by those who are highly skilled will drive down quality as well. To avoid this, a government program would have to begin ordering doctors to work with patients for less than what the market says their services are worth or even for free("pro bono" as you say) because I doubt (and would not fault) doctors for not being completely altruistic.
I take it your a public school teacher. Another example of how a government run system, as an employer, cannot attract the best and brightest to teach at public schools. Do we want our medical system to offer the same results as our public education system? Not me!
The one thing all your pseudo-economic discussion misses is an accounting for a soul. There are plenty of talented doctors who would remain in medicine because they feel a calling for that kind of work. Believe it or not, there are a lot of school teachers that feel the same way. (And don't think that it's a "public school" issue; almost all private school pay LESS than local comparable public schools.) So denigrate and rationalize all you want. I'm still waiting for doctors wh have tremendouse trouble making ends meet, and guess what? I'll have a looooooooooong wait!
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