This is a very interesting debate! As a Canadian nurse I have always believed health care should be accessible to all. However, our system costs $95 billion a year, finding ways to fund this without increasing taxes or cutting programs is extremely difficult. Canadians are debating whether the next step will be to apply user fees and allow some privatization. Before September 11th I would have said Canadians would fight against user fees and privatization, but now that the public supports spending more money on defense, I think we are more likely to see user fees implemented.
Another point I found interesting was the thought that litigation would increase if Americans felt equal access to health care was their right. I always thought Americans had higher incidence of litigation because of the free enterprize.
Mijourney, interesting thought about the impact of the babyboomers (I am one) on the healthcare system as we age. One would wonder how this will impact the thinking of the majority...
"Some Doctors Are Spurning Managed Care, Giving More Time -- and a Bigger Bill -- to Their Patients"
By Marc Borbely
"Dorothy Faul, a librarian retired from the National Gallery of Art,
received a 'Dear Patient' letter from her doctor in August that troubled her. Internist Jane Chretien announced that as of Sept. 1, she and Audrey Corson, her partner in Bethesda Physicians, would no longer participate in any health insurance plans."
"But for most of her patients, the change means having to pay in full, by cash, check or credit card, at the time of service. Then it's up to them to seek whatever reimbursement they can from their insurance company, should they choose, by submitting the itemized bill they get from their physician. Because Faul is a Medicare patient, she'll get a bit of a break: Her visit fees will be lower and her doctors are required to continue to file claims
to Medicare for her; non-Medicare patients will be given the forms to file themselves."
"Bryan Arling and David Patterson on M Street, and Beth Unger and her 10 partners on New Mexico Avenue also accept no managed care outside of Medicare."
"Michael Newman, another internist at 2021 K St. NW, has also never had contracts with private managed care companies, though he emphasizes that he sees Medicare patients and will continue to do so."
Comment: So physician outrage with managed care has prompted many of them to refuse to accept contracts with private managed care companies. They are even willing to penalize their own patients with higher out-of-pocket expenses since they reject fee limits imposed by insurers, and insurers, in turn, penalize patients for receiving care from out-of-plan physicians. BUT, isn't it ironic that these physicians, who reject fee controls and the other restrictions imposed by health plans, still accept Medicare?
What is there about Medicare that causes these renegade physicians to still accept the program? Many reasons can be given, but the fact remains that these physicians who are ardently opposed to private health plans still want to participate in our equitable, more efficient, publicly administered program of health care coverage that is universal for a given segment of our
society. Obviously, they find some redeeming value in Medicare. If public insurance is good enough for the severest critics of our health care system, shouldn't it be good enough for all of us?
Feistynurse, I believe that one of the main reasons that the physicians you wrote about are willing to accept Medicare is because they're using it as a safety net. We're all getting older and there are increasing numbers of disabled young people. For example, the phenomenon of these multi large company bailout requests we've seen since 9/11, the airlines, the postal service, insurance companies, etc. proves that despite all the rhetoric people see the government as a friend who will be there when no one else is.
Aren't they accepting Medicare because they have to by law, where they have a choice as far as commercial insurance?
Speaking of universal healthcare; once you have one source for funding, regulations, etc it cuts down on paperwork and costs tremendously, however by accepting universal healthcare we will also be rejecting any private pay/provider relationship. They lack of competition when the government is the only game in town decreases the quality of care drastically.
If we did allow private payer/provider relationships with government coverage we would be looking at a two tiered system, and how far apart are we willing to let those tiers get?
Hi. I wasn't aware there was a federal mandate for those in private practice to accept Medicare. I know of several doctors in my area who don't accept Medicare or Medicaid and I'm also aware that there are hospitals in the U.S. who had not been accepting Medicare or Medicaid. In fact, I was recently informed that there is nothing in the US Constitution making health care a right although just about everyone in this country takes the health and medical care system for granted.
As far as universal health insurance, I was under the impression that most countries that had some form of it, allowed doctors to accept private pay as well as government funding.
I feel the tier issue may be a bigger problem in the US then other countries. I've seen in passing quite a few articles about disparities in health and medical care. Our stats in terms of morbidity and mortality at birth and longevity rates rank toward the bottom of developed countries.
disher
190 Posts
This is a very interesting debate! As a Canadian nurse I have always believed health care should be accessible to all. However, our system costs $95 billion a year, finding ways to fund this without increasing taxes or cutting programs is extremely difficult. Canadians are debating whether the next step will be to apply user fees and allow some privatization. Before September 11th I would have said Canadians would fight against user fees and privatization, but now that the public supports spending more money on defense, I think we are more likely to see user fees implemented.
Another point I found interesting was the thought that litigation would increase if Americans felt equal access to health care was their right. I always thought Americans had higher incidence of litigation because of the free enterprize.