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Saturday, January 20th 2007

Charity Care Dying

From Rangel, MD (via Point of Law) comes an excellent post on the decreasing proportion of physicians providing charity care.

You should go over to Rangel’s blog to read his excellent post on how liability influences this issue, but here is a look at the figures on charity care which prompted the post,

In 2004-2005, 68 percent of doctors said they delivered some free or discounted care to low-income patients, down from the 76 percent recorded 10 years earlier, according to a national survey being released today by the Center for Studying Health System Change. The center, a nonpartisan research group funded primarily by the Robert Wood Johnson Foundation, noted that the number of uninsured people climbed to 45.5 million in 2004.

We imagine, looking at median incomes, that PCPs still do very well for themselves. It is true, there are very few doctors struggling, but the general public’s perception continues to refuse to concede that things like hundreds and hundreds of thousands of dollars in student debt, rising overhead, the cost of the bureaucracy of reimbursement actually put a squeeze on physicians.

Especially those with the worst reimbursement.

It should come as no surprise that the survey found that,

Overall, higher-paid specialists or doctors working in small private practices were more likely to provide charity care than internists, pediatricians or those employed by large managed-care companies, the survey found.

Dr. Hill, president (aka spokes person) for the AMA, responded,

“Physicians are still committed to charity care,” said J. Edward Hill, president of the American Medical Association. “Time pressures for physicians have increased enormously, and there have been income drops.”

At a time when insurers are clamping down on reimbursements, most young doctors carry an average medical-school debt of $119,000, he said. And although charity care has dipped, Hill, a family physician from Mississippi, stressed that “nearly 70 percent” of doctors still offer some.

I’ll end with a little bit of personal indignation. It wouldn’t surprise me if the figures backed up less charity care taking place in Texas,

In Texas, President Bush’s home state, “volunteer charity care is nonexistent,” said Sherry L. Hill, chief executive of the Community Health Centers of South Central Texas Inc. “It is the rare physician that will donate a day or an afternoon or morning.”

At a dinner meeting with local doctors, Hill, who is not related to the AMA president, asked if anyone would volunteer to be a substitute when the center’s staff physicians went on vacation. “I didn’t get a taker in the group,” she said.

But this woman’s single antecedal story doesn’t stack up with my years and years around the physician community in South Texas.

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