Obamacare deals blow to one-doctor medicine | UTSanDiego.com - FACTOIDS
Help us Expose Political Liars!
Find and post them ALL here!
Signup Today and help us
Expose these LIARS!
   

Obamacare deals blow to one-doctor medicine | UTSanDiego.com

 

Despite the predictions of fortune tellers in politics and think tanks, we won’t know for years whether the Affordable Care Act, otherwise known as Obamacare, will ultimately leave people sicker or healthier, richer or poorer.

Yet already the law is speeding the demise of an American small-business institution; the one-doctor medical practice.

Their problems began in the late 1990s. Government cost controls steadily eroded revenues while simultaneously boosting costs, by stacking on requirements for paperwork and accounting.

Some doctors adapted by figuring out ways to see more patients. Others just accepted falling incomes.

Now, Obamacare has delivered a major blow to productivity.

In a slow-motion version of the problems that crippled online insurance “exchanges” for months, doctors who see patients under Medicare and Medi-Cal programs have been forced by federal law to install expensive, complex software systems that sharply reduce time for patients.

photo
U-T Graphic: Medicare payments to doctors — Aaron Atencio

For many doctors, it’s the final straw. Surveys suggest that older physicians are retiring in high numbers. Younger ones are closing practices and taking jobs with integrated health systems.

Early this month, I spent a few hours with my friends Dr. Doug Moir, a heart specialist in Escondido, and his wife, Margaret, who runs the business side of their one-doc practice (which also includes a nurse and assistant).

Both Moirs are pillars of the Escondido community. Just thinking about their volunteer schedule wears me out.

Over a 40-year career, Doug has helped thousands of people, both inside and outside his practice. At a robust 72, he’d love to keep going, but he increasingly questions how long he can afford it.

“This year we’re looking at putting money into the business to keep it going,” he said.

Federal data backs up Margaret’s account of revenue pressure.

Pricing is largely set in the U.S. by Medicare, the federal program for people over 65 (most of Doug’s patients), which pays on a fee schedule that covers thousands of procedures and provides a benchmark for private insurers.

In 1997, Congress imposed a payment formula that, at first, kept pace with costs. But in 2002, the formula produced a 4.8 percent reduction, prompting lawmakers to intervene each year.

Since then, increases have ranged from zero to 1.8 percent, far below inflation.

Doug Moir is a noninvasive cardiologist, which means he doesn’t perform lucrative procedures like heart surgery or inserting stents. As a specialist, he can’t easily crank up patient throughput by handing off procedures to less-skilled assistants.

Payment problems

According to Medicare’s database, Doug’s average payment in 2012 was $52.70 for a Doppler echocardiogram, which uses sound waves to peer inside a working heart. In 2011, the national average was $86.64.

Under a quirk in the Medicare formula that is eventually being fixed, payments are lower in San Diego County, which the government viewed as a low-cost, rural county.

Both figures strike me as modest; medical references say an echocardiogram can take from 20 minutes to one hour to complete.

My plumber often gets a better hourly rate. And my plumber usually gets paid.

Page 1 of 3... Read More

 
comments powered by Disqus
 
 
No Liar of the Day has been posted yet. Post yours and vote today
Please help us support this website. Any tiny donation helps us keep up the Good Fight!
Headline
Adam Schiff, Democrats, Media Play Orwellian Word Games to Deny 'Spygate' | Breitbart
Hillary Clinton blames her loss on Capitalism - Democrats are Socialists according to her!
Rosie O'Donnell Used 5 Addresses, 4 Names in Over-Sized Dem Donations
Nancy Pelosi Refuses to Call on Tony Cardenas to Resign After Child Molestation Claim | Breitbart
Recent Articles
Recent Articles







 
 

Aggregated content may contain copyrighted material. Such material is made available for educational purposes only. This constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law.