Physicians

Doctor fee stalemate exemplifies problems of universal health care

The thousands of physicians and millions of Medicare beneficiaries who think the government should provide “universal health care” insurance to all Americans are getting a good look at how ugly such a politically-driven scheme would be. Doctors would see their incomes fall, and patients would suffer big time.

Because Congress cannot agree on how to prevent a 10.6 percent cut in Medicare payments, doctors are threatening to drop their Medicare patients. And because the Democrats want to prevent the cut in Medicare payments to doctors by cutting payments to private insurers that cover millions of Medicare beneficiaries, insurers are threatening to drop out of that program and make those Medicare beneficiaries very unhappy.

The Washington Post’s report on the politically-driven stalemate is here. Clearly, the Democrats are intent on winning political points regardless of what happens to patients. And the Republicans are intent on preserving Medicare Advantage, which they created when they controlled Congress.

Under a “universal health insurance system,” which is advocated by the Democrats, political fights like this would happen every year. Doctors and insurers, if they were still in business, would face payment cuts. Patients would face uncertainty about who their doctors and insurers would be. And relationships between doctors, insurers and patients would become more strained than some of them already are.

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Chiropractic EMRSwansonspencerClínica Fisioterapiajason Recent comment authors
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Chiropractic EMR
Guest

I would like to Thanks for the informative post. Some patients avoided long waits for medical services by paying for private treatment. In 2003, British Columbia enacted Bill 82, an “Amendment to Strengthen Legislation and Protect Patients. Health care can have a zero price to the user, but that doesn’t mean it’s free or has a zero cost. The problem with a good or service having a zero price is that demand will exceed supply. I’m wondering just how many Americans would like Canada’s long waiting lists, medical czars deciding what treatments we get and an exodus of doctors. Thanks… Read more »

Swanson
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Swanson

With a Universal Health care system there is no dought there will be less personalization with doctors and patients, because patients will be seen by whoever is available at that time. This would lead to “cookie cutter diagnoses” and treatment.It will become more of a business and the bottom line is volume. If a doctor had a patient for many years the likelihood of catching something in early stages are higher than not. Due to the experience the Doctor had with this patient over the years. But that patient doctor relationship would be eliminated. Malpractice suits will double if not… Read more »

spencer
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spencer

“no money = no initiative. these bright individuals will find their place in other fields of the private sector”.
I wonder which other fields of private sector offers the financial reward close to medicine.
Pls tell me how we get the capable,committed individuals in the armed forces. It is called professional interest. As a matter of fact, the least desirable doctor is the one that entered the profession purely for money !!

Clínica Fisioterapia
Guest

nice blog…congratulations from Brazil..thanks!

jason
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jason

i think we are all ignoring the human nature of incentive. all benefits of any of the systems aside, how do you get people who want to become doctors to pay for all the schooling required and invest years of their lives to training to accept drastic reduction in payment that all of these socialized systems of health care would cause. no money = no initiative. these bright individuals will find their place in other fields of the private sector. also coverage does not equal care. ask the canadians and the british about gate keepers and long waiting times. we… Read more »

Matt
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Matt

Did you see the Bunk study stating 2/3 of doctors in America want National Health Care. The doctors who did this study also conducted one in 2002 and found that the majority of doctors did not want national health care, the problem with this is that the 2 question surveys drastically differ in there 2nd question. I found this article, 60% of Physicians Surveyed Oppose Switching to a National Health Care Plan, It’s worth a read.

Peter
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Peter

“Am I mistaken to this that the “universal” system Peter describes treats doctors almost like slaves? That is, their choices are to either play by the rules, leave the country, or quit?” Brian, it’s called collective barganing, not beneath doctors and gives them many more options than other workers in the economy. If you consider the options for docs to be that narrow then what is your reaction to strikes in other industies and your view of worker options then – do you say, “If they don’t like the working conditions then find another job”? People entering the profession in… Read more »

J Bean
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J Bean

My understanding is that it was (maybe still is) illegal to run a private practice in Canada; if you wanted to practice medicine you worked for the government. That is Universal Care. Your understanding is off by quite a long way. The systems vary substantially from country to country. In Canada many, if not most, docs are in private practice. In some provinces, however, it is illegal to buy private insurance. In the UK most docs are government employees, however it is quite legal to see private patients too. In Germany and Switzerland private insurance is paid for by a… Read more »

Marco Lugon
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Marco Lugon

My understanding is that it was (maybe still is) illegal to run a private practice in Canada; if you wanted to practice medicine you worked for the government. That is Universal Care. However, many countries (including Canada) with universal care systems are moving toward a parallel system, where they allow doctors to set up private shops (Germany and I believe Sweden have done this). It makes you wonder why Universal Care is something people aspire to? A ‘single payer system’ would presumably mean that the government pays for everything, but private contractors (doctors) would provide the services … think Defense… Read more »

Brian T. Schwartz
Guest

Peter writes: “A true ‘universal’ system does not involve private insurance or a two tier level of service that doctors can run to when they are unhappy with the “government” tier.”
Am I mistaken to this that the “universal” system Peter describes treats doctors almost like slaves? That is, their choices are to either play by the rules, leave the country, or quit? Is this a respectful way to treat those who can save your life?

Doug Rogers
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Doug Rogers

The debate over whether to allow a reduction in Medicare physician fees or not is not connected to the concept of universal health insurance. There are many models currently in circulation that provide a roadmap to universal coverage while still enabling a private insurance market. Unfortunately, you are confusing universal coverage and a single payor system. I find it hard to fathom that people would advocate against universal coverage. It is hard to understand an argument that justifies anyone in the United States being denied health care services because of their economic status. The very principle of universal coverage is… Read more »

Paul Hsieh
Guest

Instead under a “single payer” system, when there’s a dispute between what a government is willing to pay physicians and what physicians need to make in order to stay afloat, we get the problem of doctors’ strikes, as has happened in countries like Germany multiple times in recent years.

Peter
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Peter

A true “universal” system does not involve private insurance or a two tier level of service that doctors can run to when they are unhappy with the “government” tier. If universal is going to work then we all have to be in the same system and have the same committment to its success. Trying to keep the old system while tinkering with a new one will mean failure and continuing escalating costs. Universal unfortunately for too many people means pay for all my healthcare wants, and pay the price I want – not going to happen.