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Which has been discussed on C-Span for a good long while now. Something about enrollments to medical schools being limited by the government. We have a doctor shortage, especially in rural areas. Low Medicare reimbursements don't help.
Residency slots are set by Congress through Graduate Medical Education. That's in part because some medicare money goes towards that.
It's been capped since 1997.
Since it's capped medical schools cannot expand because you can't become a doctor without residency.
If you want more doctors then Congress has to raise the cap. Raise the cap and that will cost more which comes from medicare. Medicare isn't in the best financial shape these days.
In fact the GME program funding was threatened to get cut with the sequester bickering that went on.
I found out about this information during the Obamacare debates about doctor shortages and why.
anifani821, I thought it was an informative post. It was a firsthand story of what many of us have known all along and have read about in articles.
Sorry you got bashed so hard for your story.
People read MSM articles saying the same thing and believe them yet when people tell firsthand stories they are bashed.
I'm not even on medicare and had a hard time finding a new doctor when I moved.
"Sorry we're not taking new patients".
While I found one, appts are far and few in-between. Ended up at the county health clinic to get a TB skin test for school because they had no open appts for 3 months. Well I couldn't wait 3 months for a 5 minute procedure that required a follow-up in 3 days.
Yes, I do know what you mean about finding a doc and getting a timely appointment!
I am at our mountain house now and need a doc here. After much searching as to who friends and family felt was "the best," the first doc is not accepting new patients (any new patients, of any age) and the second doc could not see me until September. At that time I called, that was right at 2 months' wait. I thought that was unfortunate, but after talking with friends here, I was told that was not unusual and that I should feel lucky it wasn't a longer wait!
EDITED TO ADD: I am not a Medicare recipient - that is still a few years off.
Last edited by brokensky; 08-03-2013 at 09:03 PM..
NEG: I didn't directly answer your question about folks who do or don't have Medicare . . . and why a physician practice would ASSUME one has Medicare.
Most people over 65 DO have Medicare, at least in this particular region.
My thought was . . . if a receptionist says "We are not taking any more Medicare patients" . . . then that would mean the caller could challenge/correct the misperception. It would be interesting to know if the receptionist would change her stance on "not accepting Medicare patients" if he/she were then informed that the caller is NOT a Medicare patient and would be either using some other form of insurance or self-pay.
One thing I can assure you about, however . . . this all comes down to reimbursement, and that is two=fold. Seniors tend to take up more time, per patient, both with in-office appts and with time spent with patients on site. So that cuts down on productivity. Then you add reimbursement issues . . .
We here much about folks going bankrupt fom medical cost? Hmmm that is a good reason for any business to reconsider their business model if they aren't getting paid. Giving people insurance to pay part of the cost at a reduced rate is bad enough but when they can't or won't pay the balance what do you expect?.
Residency slots are set by Congress through Graduate Medical Education. That's in part because some medicare money goes towards that.
It's been capped since 1997.
Since it's capped medical schools cannot expand because you can't become a doctor without residency.
If you want more doctors then Congress has to raise the cap. Raise the cap and that will cost more which comes from medicare. Medicare isn't in the best financial shape these days.
In fact the GME program funding was threatened to get cut with the sequester bickering that went on.
I found out about this information during the Obamacare debates about doctor shortages and why.
Thanks for the details on that. Last guy I saw on C-Span (a 40ish doc employed by the govt) was stressing the urgency and at the same time trying (in my mind unsuccessfully) to dial down the alarm factor. Country is pretty far behind the curve it appears, seeing as how it takes about 10 years to train a doc. Should have dealt with enrollment issue long ago.
Thanks for the details on that. Last guy I saw on C-Span (a 40ish doc employed by the govt) was stressing the urgency and at the same time trying (in my mind unsuccessfully) to dial down the alarm factor. Country is pretty far behind the curve it appears, seeing as how it takes about 10 years to train a doc. Should have dealt with enrollment issue long ago.
ACA has provisions for increasing access to care through use of healthcare professionals other than physicians themselves.
THis is nothing new (as you doubtless know) -- as many physician practices have been using PAs and/or nurse practitioners as gatekeepers.
What has me perplexed is why ACA has been touted as offering assistance (through financial aid) to people who want to enter the healthcare field . . . but the assistance is being offered only to MINORITIES. That is just wrong to give preference to someone b/c of race. I find it very disturbing that my son, who is in healthcare, has to pay for his further education while someone else who is a minority won't have to pay for theirs. This is not correcting any sort of disparity -- it is blatantly discriminatory. I don't care what rhetoric is tagged on . . . if the goal is to get more qualified healthcare workers into the field (or help them with further education in their field) either you assist everyone who is qualified or you assist no one.
I don't understand why the public does not find this method of distributing tax dollars to only one group extremely unfair and discriminatory.
My primary sent out a letter to all patients telling us that she was leaving the practice to become a specialist at a big hospital here. My niece, who is a doctor, tells me that many are going that route. I would love to know the driving factor—more satisfaction, higher pay, less hassle with insurance reimbursement, seeing the medicare scenario down the road, or a combination. I do know that for a specialist I am having to wait two months out for an appt. and that I can get on a wait list for an earlier appt. As many of us hit age 65 I wonder what our options are going to be in the remainder of our lifetimes. Will we possibly die waiting for an appt?
My primary sent out a letter to all patients telling us that she was leaving the practice to become a specialist at a big hospital here. My niece, who is a doctor, tells me that many are going that route. I would love to know the driving factor—more satisfaction, higher pay, less hassle with insurance reimbursement, seeing the medicare scenario down the road, or a combination. I do know that for a specialist I am having to wait two months out for an appt. and that I can get on a wait list for an earlier appt. As many of us hit age 65 I wonder what our options are going to be in the remainder of our lifetimes. Will we possibly die waiting for an appt?
You have folks trying to redesign the market based on ideology while ignoring natural market forces. The intent may be admirable but individuals often will act in their best interest. There are certain factors we can't ignore.
Shortage of medical personnel
Many without the ability to pay their bill
Many unwilling to pay their bill
The right of practitioners to practice where they want an to whom they want
In the case you present among other things she is transferring the cost and risk of having her own practice to someone else.
We have many on here saying they want to die broke does that mean not paying their medical bills towards the end? Hedge your bets and save to be able to afford concierge service. Doctors can control costs, work lad and get their money up front and you can get your app't on short notice, probably even a house call. Market forces are market forces and hard to buck without causing things to crash. You can say it is wrong but it is their resources at work to be deployed how they want.
Reading through all these posts causes me think, in no particular order; Oy vey! No good deed goes unpunished.; and,There is no doubt in my mind that regional and political bias' inform our perspective, if not also, the understanding of a very complex issue.
Oy vey! God Bless us all. Oh, and no offense intended to the atheist, agnostics and humanists amongst us.
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