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Tuesday, September 13th 2005

In A Bind…

Physicians have worked themselves into a bind. They’ve waited too long to ‘battle’ the proliferation of Medicare. Now that Medicare controls such a large percentage of the insurance market (although talking about it like this sounds mildly ridiculous) it can dictate physician payment without consequence. Certainly without the dramatic consequences some physicians claim a decrease in compensation will lead to.

When Medicare first began it was a free wheeling program (as much as a government program can be) that allowed a large physician influence in what it paid them for procedures. As it stands today, the government compensation formulas used to determine what a physician is paid for an office visit or procedure (and is going to be modified shortly to cut physician compensation by 4.3%) make Medicare one of the worst ‘insurances,’ from a physician’s perspective.

However, as an article here points out, claims by physicians, especially general practitioners that cuts in Medicare compensation will result in a shortage of doctor’s participating in Medicare, rings hollow. Too many physicians have practices where Medicare patients may make up more than 50% of the population. Under such conditions the physician can ill afford to forgo such patients (even if s/he is losing money on every office visit).

Blogs like Kevin, M.D. have made a series out of talking about how poorly general practitioners are paid compared to their ‘specialized’ physician counterparts. An element in this (although compensation across all insurances for office visits is abysmal) is the number of general practitioners who rely on Medicare patients. The more specialized the field in medicine the less impact Medicare compensation rates can have over your income.