When Doctors go John Galt

[ALS]

By MARC SIEGEL

Here's something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn't automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especially government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have.

Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients. The statistics are similar in New York state, where I practice medicine.

More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I've had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider -- who they liked -- abruptly stopped taking Medicare. One of the top mammographers in New York City works in my office building, but she no longer accepts Medicare and charges patients more than $300 cash for each procedure. I continue to send my elderly women patients downstairs for the test because she is so good, but no one is happy about paying.

The problem is even worse with Medicaid. A 2005 Community Tracking Physician survey showed that only 50% of physicians accept this insurance. I am now one of the ones who doesn't take it. I realized a few years ago that it wasn't worth the money to file the paperwork for the $25 or less that I received for an office visit. HMOs are problematic as well. Recent surveys from New York show a 10% yearly dropout rate from the state's largest HMO, the Health Insurance Plan of New York (HIP), and a 14% drop-out rate from Health Net of New York, another big HMO.

The dropout rate is less at major medical centers such as New York University's Langone Medical Center where I work, or Mount Sinai Medical Center, because larger physician networks have more leverage when choosing health plans. Still, I am frequently hamstrung as I try to find a good surgeon or specialist to refer one of my patients to.

Overall, 11% of the doctors at NYU Langone don't participate in at least two insurance plans -- Aetna or Blue Cross, for instance -- so I end up not being able to refer my patients to some of our top specialists. This problem, in addition to the mass of paperwork and diminishing reimbursements, is enough of a reason for me to consider dropping out as well.

Bottom line: None of the current plans, government or private, provide my patients with the care they need. And the care that is provided is increasingly expensive and requires a big battle for approvals. Of course, we're promised by the Obama administration that universal health insurance will avoid all these problems. But how is that possible when you consider that the medical turnstiles will be the same as they are now, only they will be clogged with more and more patients? The doctors that remain in this expanded system will be even more overwhelmed than we are now.

I wouldn't want to be a patient when that happens.

Dr. Siegel, an internist and associate professor of medicine at the NYU Langone Medical Center, is a Fox News medical contributor.


online.wsj.com

[Howard Bullock]

I wonder how many that read this thread have no understanding of the John Galt reference.

For those that don't know, John Galt is a character in Ayn Rand's novel "Atlas Shrugged" where the productive motor of the world is stopped by the disappearance of intelligent productive producers of the world. You should read the book if you have a desire to know more.

[JoeWilliams]

Drs. will not be allowed to go "John Galt." They will be required to accept the government health plans, and only allowed to charge what the government says they can. Going cash only will not be permitted.

True, some Drs will simply retire, but there are bunches that are simply too young and in debt to do so right away. Wonder how good a job these Drs will do when my life is on the line, considering that even with our current excellent health care system doctors still kill more people every year than guns do?

For me, the real question isn't going to be an issue for 5-10 years, when we will then have to ask: "What good is universal government sponsored health care, when there aren't any doctors left to provide it?"

[ALS]

I have women neighbor in Naples Fl. that is around 75 who has gone through I think five general practice doctors in eight years. Reason? A lot of the doctors in south west Florida have stopped taking Medicare and Medicaid. They also dumped the states low income insurance plan. Private insurance, cash, check, or charge card is the only way into their office.

In Pa. about five or six years ago they were reporting that less than 4% of the doctors in the state were thirty five or younger. Do the math on that one boys and girls. Can you say bend over and prepare to take it up the *** in the next twenty years or so. Reason for this? Read on.

Back in 2004 or 2005 they were reporting that the number of malpractice suits filed between 1999 and 2004 worked out to, that two out of every five doctors in Pennsylvania had a malpractice suit filed against them.

No doctor is going practice in a state where your a winning lottery ticket in waiting.

[Morel42]

Just to be clear.

Medicare = Age 65 or older system
Medicaid = Welfare System Health Care

The two systems have a totally different network of Doctors.

29% of all patients looking for a NEW doctor have problems finding one that takes Medicare. Medicaid has been and always was hard to find doctors who particapate in it.

If all Doctors stopped taking Medicare the system would instantly collapse lol..

[Brick]

And you have just outlined the weakness in the Messiah's whole medical scheme. He hasn't considered how to increase the number of not only "participating physicians", but physicians period!

[X-Man]

There is yet another side to the health insurance problem; should one need a procedure or operation who gets to say which technique will be utilized? The best, or a quick and easy for the doctor let's save a buck get 'em in and out?
I've also heard of cases where the insurance company refused to make a decision to the point where it became impossible to provide any care to the patient, since the patient has gone past a certain point of possible recovery.

[GunLawyer001]

This is not a problem for the government of Hope & Change: They will simply pass a law requiring all doctors to accept the government plan, or lose their medical license.

The result will be more lawyers and Wall Street money manipulators every year, and fewer doctors. Then, the government will have to start drafting teens to go into medical school...

[knight0334]

This is not a problem for the government of Hope & Change: They will simply pass a law requiring all doctors to accept the government plan, or lose their medical license.

The result will be more lawyers and Wall Street money manipulators every year, and fewer doctors. Then, the government will have to start drafting teens to go into medical school...

After of course they have fulfilled their Obama Youth conscription.

[Morel42]

And you have just outlined the weakness in the Messiah's whole medical scheme. He hasn't considered how to increase the number of not only "participating physicians", but physicians period!

So which is it?

Killing off Private insurance with a Gov't sponsored healthcare plan..

Or.

Creating a Healthcare plan that nobody wants?


I think the idea is that it provides at least the basic minimum of health care to people.. Or to keep families from going bankrupt when their private health insurance drops them when they discover dad has Cancer..

Has anyone here ever NOT had health care insurance when it was critical to have it?