Seattle: Many doctors opting out of Medicare

[NRSKarenRN, BSN, RN]

By Carol M. Ostrom

Seattle Times staff reporter

http://seattletimes.nwsource.com/html/localnews/134397337_wsma30m.html

The doctors delivered their diagnosis yesterday: Washington's health-care system is in serious decline, and the prognosis is guarded.

Tests show the severity of the problem, said Tom Curry, executive director of the Washington State Medical Association, which released a gloomy report in Olympia.

Responding to an informal poll of members in November, 57 percent of physicians said they are limiting the number or dropping all Medicare patients from their practices, the report says.

In a different poll last month, 30 percent of physicians said they had begun limiting Medicaid Healthy Options and Basic Health Plan patients they will treat. An additional 28 percent said they'd decided to drop all Healthy Options patients up from 10 percent from a poll a year earlier and 24 percent said they would drop all patients covered by the Basic Health Plan, the state's program for low-income residents.

Curry blamed the doctors' decisions on low federal and state reimbursements.

The report was compiled by an arm of the medical association.

The report, which represents the views of doctors, is not just about doctors' well-being, the association argued: It's about the ability of patients in the state to get care and about the state's economic health as well.

The report says that for many years the state's health-care delivery system has been in decline, characterized by a slow erosion of funding for public health, growing administrative expenses for practitioners and mounting frustrations of physicians trying to cope with myriad regulations.

A growing number of patients, even those with private insurance, are having trouble finding a physician because increasing numbers of doctors have been leaving the state or retiring early since the late 1990s, the report says.

And as the capacity of medical groups to absorb more patients shrinks, hospital emergency rooms are becoming increasingly crowded, the report says.

As for low reimbursements in subsidized health plans, the report compared Medicaid payments with some other common expenses.

For example, for an office visit, a doctor is reimbursed by Medicaid just $13.40, the report says. By contrast, the cost of a take-out pizza is $19. For a skin biopsy, the doctor is reimbursed $26.89, while a person would pay $40 to go to a tanning salon.

There will be no "magic pill" for the state's health-care ills, said Curry.

But the association is actively promoting some small-scale reforms, both state and federal, that could make a difference, he said.

Curry said the association also supports changing the federal tax code to allow individuals, as well as employers, to reap tax breaks for buying health insurance.

Copyright © 2002 The Seattle Times Company

[Mijourney]

Hi. I guess this means that many of us aging nurses will be out of luck when we need help from doctors. If we don't hit the magic jackpot in our personal incomes and don't have the right type of insurance, we might as well step aside in one way or another. Is that what is being implied here?

I think I saw not too long ago where there was a segment on one of the cable channels about doctors who were charging their patients, who could afford it, money out of pocket for more "bedside" time. Many of these doctors where found to also be billing insurance companies for services as well. Does anyone see a problem with that? Maybe? Maybe not? Is this the doctors way of charging tips or gratuity? Any NPs out there got any thoughts?

[teeituptom, BSN, RN]

I dont blame them at all for doing that, They are just like anybody else. Trying to make a living at what they love to do. Their lifes avocation. Yes Us older nurses may well have problems a few years down the road. Unless were well prepared.

One of my best friends specializes in Internal Medicine. After he pays for the cost of his office, his loans,his staff and their benefits. He is making less a year than I am. When we go golfing does he being a so percieved rich doctor, can he afford to pick up the tab. NO, he cant afford to. Does he belong to some ritzy golf country club, NO. He can only play the public courses like I choose to do, And he generally has to play the cheaper ones, at that. He has a high percentage of medicaid and medicare patients, and he has to work longer hours than I do to make ends meet.

So with all these decreaseing reimbursement schedules, their profit margins are down. So I would not blame any doctor who elects to drop or stop caring for patients with medicaid/medicare or any of those other ridiculously low reimbursement plans. Is this a problem that will increase, I believe it will. So do you or you wouldnt have initiated this thread. And its not just in your neck of the woods its all over. And here also I dont know what the answer is, But we the people of this country need to come up with one. May be a tax based national health care system will have to be the answer. I hope something is done before I have to retire.

just a different look

Thomas livingston RN