Every doctor I’ve talked to says he loses mucho money on MediCare and Medicaid patients — that shouldn’t be new news to anyone.
Some tell me that Medicaid patients are especially troublesome because they account for a disproportionate “no shows” — patients who schedule an appointment but don’t post for it. Why ? No skin in the game.
ObamaCare is largely funded by containing physician reimbursements on MediCare and Medicaid … concurrent with swelling the Medicaid rolls by about 15 million people.
In the past, docs have offset their MediCare and Medicaid losses by, in effect, charging privately insureds more.
So what’s going to happen ? It’s pretty easy to predict:
- The ‘natural’ proportion of gov’t insured patients (MediCare and Medicaid) will increase.
- Docs will try to cross subsidize them by increasing privately insured rates.
- But, ObamaCare police will cap the private insurance premiums.
- So, docs will start restricting the number of gov’t insured patients they treat … some will stop treating gov’t insured patients all together.
- Then, ObamaCare police will will call “foul” and mandate that all doctors must treat a minimum number of gov’t insured patients.
Just wait and see … you can smell this one a mile away (from the White House)
The Homa Files 
March 24, 2010 at 12:52 pm |
This is the most obvious thing you’ve ever posted. You can only mandate against greed (some people think that greed is irrational behavior, but I just smile whenever they say that).
March 24, 2010 at 1:25 pm |
Sure, it may be “obvious,” but while Nancy and Barry break their arms patting themselves on the back this week for their victory (a victory over the people, I might add), it is worth calling attention to this.
March 24, 2010 at 2:54 pm |
Actually, this has already happened in Massachusetts. Physicians (already a shortage by the way) reduced the number Medi* patients they were willing to see and the state responded by imposing minimums. Docs then consolidated those appointments and reduced their face time, or pushed them off to future dates so that patients would opt for a different physician.
The complexity is what physicians are going to do with all of the new patients now able to enter the system. On the upside, some of them may move to preventative care rather than the ED visit they usually rely upon. The research suggests that more managed care results in less hospital use (good), but more physician use. Recent testimony indicates a shortage of 40k primary care docs over the next few years with that number growting to 125k by 2025. Those shortages are projected from last year and do not take into account the influx. Certainly they aren’t going to opt to work harder for less money.
One added ruffle – most physicians graduate with $140k in debt. Know anyone who would take on $140k in debt for a job eating a 21% pay cut?
Complex issue. Too deep for the sound-bite minds.
April 13, 2010 at 11:27 am |
quod erat demonstrandum:
“Experts warn there won’t be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.”
http://online.wsj.com/article/SB10001424052702304506904575180331528424238.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsSecond