Wednesday, March 3, 2010

Medicare editorial from BackTalkLive

Just as I was preparing my editorial on medicare, CNN asked me for an interview about my perspective on medicare. What did I tell them? It's a SHAM because it doesn't pay doctors who want to practice quality medicine enough to stay in practice. So how can they stay in practice? From the income private insurance pays. This means that medicare is a subsidized insurance program, like a charity. Primary care doctors either have a patient mill with a squad of physician extenders such as nurse practitioners and physician assitants (most are very competent) working for them or they can't make a living. That's why so often you don't even get to see your doctor or if you're lucky, maybe for five minutes and that's after waiting for an appointment for a ridiculous amount of time. I, a surgeon, opted out of medicare because I didn't want to support a sham. It doesn't come close to even covering my costs so I want my patients to know the truth. I ask them if they can pay a reasonable fee, I never want them to go broke but I want to at least cover my expenses. If they can't pay anything and are determined to have me perform their surgery, I will do my best to work something out. Not all doctors are prepared to do this, they just can't carry the losses. If my only reimbursement was medicare based, I would have to perform over 500 operations before I saw a penny of it myself. None-the-less I always give the best of myself no matter whether my over 65 patients can pay or not. Most of my patients do choose to pay because they want to feel good about selecting the doctor of their choice. With medicare further cutting payments, more doctors will be forced to opt out and patients will all have to pay more out of pocket or receive second class medical care.

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