More Docs Reject Privately Insured Patients!

A study expecting to find even fewer doctors willing to accept new Medicare patients found, sure enough, a modest drop in that percentage. But the shocker was a far steeper decline for doctors willing to accept privately insured patients.
The study shows 93.3 percent of doctors accepting insurance for payment in 2005, and 87.8 accepting insurance in 2008.

The drop for those accepting Medicare coverage during the same time was 95.5 percent down to 92.9 percent. Not the huge difference the right-wing media has been harping about - and they seem to have missed completely the fact that some doctors turn away patients wanting to pay with private insurance.

I first heard of this a few years ago with a doctor in Fort Collins, Colo., who wouldn't accept private insurance. He said he did so so he could practice medicine instead of argue with bureaucrats whose primary concern was profit, not patients. The insurance companies also didn't pay him enough - and he's a family doctor, not a country-club suburban specialist.

Dr. Tara Bishop's study was in the 27 June 2011 Archives of Internal Medicine. She's assistant professor of public health at Weill Cornell Medical College and practices at New York-Presbyterian Hospital/Weill Cornell Medical Center. Dr. Bishop is concerned that the growing numbers of physicians saying no thanks to insurance companies could bollocks up President Obama's reform - which depends on everyone buying private health insurance from this deadly industry.

It's one more reason to simply expand Medicare to cover everyone.

There are economic sectors where the free market delivers most effectively, no doubt. Manufacturing computers and running casinos come to mind. Other tasks - like covering the cost of health care, fighting fires, policing our communities, educating all the children - societies that tax themselves to provide those services for all come out ahead.

Pretty simple. You want the Pakistan model or Paris?

The problem for American docs

We don't talk very often about the role that physicians play in our sick healthcare system. Most of them are unhappy with their loss of control and the fact that they can't just concentrate on healing patients — but instead need to be businessmen and now employees of the HMOs and PPOs, getting permission for every procedure.

Statistics show that a majority of medical students begin idealistically, planning to be primary care physicians. By the time they graduate, however, faced with medical school debt of more than a quarter million dollars, most decide they need to go into a specialty, where they will earn more money.

This article, about an opinionated older physician, quotes him saying that "the amount of money involved in the system brings out one of the more negative human attributes -- greed.

"'Unless and until these extraordinary costs unique to the United States are squashed into manageability, there is too much greed and too little control of greed being exercised,' said Bennett, a Harvard Medical School graduate, who operates a practice that bases its fees on the ability of his patients to pay. 'It does not matter what politician suggests what plan --- Republican or Democratic, that plan will fail.'"

He goes on to list four specific physician-related issues:

• the educational debt carried by new doctors;
• the practice of hospitals "owning" the physicians who are affiliated with them;
• extraordinarily high prescription drug costs; and
• the advent of health management organizations, which have assumed a middleman position between patients, health care providers, pharmaceutical companies and hospitals.

Yep.

Bravo to Larry Smith

Donna Smith yesterday posted an entry on Michael Moore's blogsite about her husband Larry's rather brilliant idea about unionizing patients. It's pretty simple. Don't patronize doctors who aren't for single-payer, universal health care. Larry's a union man, and it shows in his thinking here. (By the way, if you've never heard Natalie Merchant sing this classic, you'll be richer for finding a way to hear it.)

WHICH SIDE ARE YOU ON?

Florence Reece/ Stormking Music, Inc.(BMI)

Come all you good workers
good news to you I’ll tell
of how the good old union
has come in here to dwell

Which side are you on boys?
Which side are you on?

My daddy was a miner
he’s now in the air and sun
he’ll be with you fellow workers
until the battle’s won

Which side are you on boys?
Which side are you on?

They say in Harlan County
there are no neutrals there
you’ll either be a union man
or a thug for J. H. Claire

Which side are you on boys?
Which side are you on?

Oh workers can you stand it?
oh tell me how you can
will you be a lousy scab
or will you be a man?

Which side are you on boys?
Which side are you on?

Don’t scab for the bosses
don’t listen to their lies
poor folks ain’t got a chance
unless they organize

Which side are you on boys?
Which side are you on?

Minnesota docs prefer single-payer

Impressively, 63.4 percent of Minnesota physicians said a single-payer healthcare system would offer the best healthcare to the greatest number of people. That's quite a few more than the 25 percent of physicians who thought health savings account systems were best, or the 11.8 percent who were in favor of managed care.

It's not the best study in the world — the University of Minnesota mailed out a thousand questionnaires to randomly chosen Minnesota physicians, got 39 percent back and called it good — but you can't really say that pro-single-payer doctors would be more likely to mail it back than other docs. They'd be more likely to mail it back than doctors who didn't know or didn't care, but it's probably actually the anti-single-payer physicians who would be most anxious to get the survey in.

The tide's not moving in their direction, after all.