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Old 08-29-2009, 02:30 PM
 
25,591 posts, read 15,264,868 times
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Hey it is okay. We do not HAVE TO see medicare and medicaid patients. We lose money on them already. Most will just refuse to see them, as you can't go broke practicing. We balance profits from private insurance vs the losses from medicare and medicaid. The same with "government" insurance. You can have all the insurance you want, but if no one accepts it, it is not good for anything.
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Old 08-29-2009, 02:53 PM
 
Location: Pinal County, Arizona
25,106 posts, read 37,130,543 times
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Originally Posted by hawkeye2009 View Post
Hey it is okay. We do not HAVE TO see medicare and medicaid patients.
My wife, a physican, has stopped taking Medicare.
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Old 08-29-2009, 03:26 PM
 
10,720 posts, read 18,940,184 times
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I'm a cardiologist. Let's focus on the patient. Let me give you an example of what could occur. I used to treat patients in our veterans hospital. I've observed several examples of patients(veterans) with a history of angina and several risk factors presenting to private hospitals. The cardiologists who saw those veteran patients at those hospitals recommended an angiogram(catheterization). The VA refused to pay for those patients to undergo this treatment and made those patients come to the VA to be admitted. The patients would not receive those angiograms because they didn't present with all the classical signs of ischemia or myocardial injury. Because of that, we couldn't get an angiogram approved even though I personally felt these patients should have gotten one.

People only discuss Medicare with regards to govt healthcare but there are forms of govt healthcare like the VA, the Indian Health System, and Medicaid. No one knows for certain how a Govt. option will function but those of us actually seeing patients in these systems have observed rationing first hand. And this is what scares us. I wouldn't want this type of VA care applied to the general public. I believe in health care reform. We do need to increase access but I don't believe in lowering the quality of care. And the idea of rationing is a very real possibility. In most countries with UHC, they pay much higher taxes to pay for their healthcare and serve a much smaller population. We are not going to drasticaly alter our tax structure to reflect these countries. The money has to come from somewhere. As more people join the public option, they are going to have to find a way to pay for all those patients and usually the govt will ration care as we have witnessed first hand in the VA and Indian Health System.
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Old 08-29-2009, 03:38 PM
 
10,720 posts, read 18,940,184 times
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Originally Posted by Jareb View Post
Having worked in the field of cardiology for the past 35 years, I have some insight through several frienships with cardiologists. This past week a few of us were discussing the projected cuts to cardiology. Each one {MD's} had misgivings about health care reform but more specifically, they were very concerned about the projected cuts. To a person, they stated; "We will go to a pay-for-service practice" where only cash paying and private insurance patients will be seen. They were discussing not accepting any medicare, medicaid or public option payments. Now, I'm not trying to imply that this is any greater than the several people involved in this discussion, but it certainly could evolve into something larger if cuts are made. This isnt posted to be pro or anti health care reform...its just an observation from someone involved.
It's true. What will happen is patients with a history of CAD or at high risk will take it upon themselves to pay more and purchase private health insurance knowing their access to care will be drastically limited under the public option since most cardiologists won't accept the public option plans if they don't provide fair compensation. There are so many doctors that don't accept Medicaid. I know physicians in certainly highly specialized fields that don't accept any Medicaid plans because they don't provide fair compensation to the physicians meaning it costs the physicians to treat the patients under those plans. It's so bad that if a Medicaid patient wants to see this type of specialist in the Phoenix metro, there are only 1 or 2 providers in the entire metro of 4.2 million. The last I knew, there was only one provider in the entire city that accepted Medicaid in this field. This is happening NOW!
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Old 08-29-2009, 04:59 PM
 
Location: Murfreesboro, TN
764 posts, read 2,393,314 times
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Originally Posted by azriverfan. View Post
It's true. What will happen is patients with a history of CAD or at high risk will take it upon themselves to pay more and purchase private health insurance knowing their access to care will be drastically limited under the public option since most cardiologists won't accept the public option plans if they don't provide fair compensation. There are so many doctors that don't accept Medicaid. I know physicians in certainly highly specialized fields that don't accept any Medicaid plans because they don't provide fair compensation to the physicians meaning it costs the physicians to treat the patients under those plans. It's so bad that if a Medicaid patient wants to see this type of specialist in the Phoenix metro, there are only 1 or 2 providers in the entire metro of 4.2 million. The last I knew, there was only one provider in the entire city that accepted Medicaid in this field. This is happening NOW!
Absolutely. I have an elderly mother on Medicare and a retarded brother on TennCare (Medicaid.) Their selection of specialists in Nashville, TN is extremely limited. So many PCP's have stopped accepting govt plans or limit how many patients they accept that when my Mom's PCP passed away last year, she had a very hard time finding someone to go to.
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Old 09-03-2009, 01:06 PM
 
841 posts, read 862,308 times
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Originally Posted by TigerLily24 View Post
Of course they are worried. More preventative care means less need for oncologists and cardiologists. Protecting their little fiefdoms sounds more like.
For real preventative care for cardio and cancer they would have to and should clear out most of the supermarket so called foods, and the fast food restaurants.
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