2018-01-09 15:42:05 UTC
Why did we let Obama cut $716 Billion from Medicare?
One In Five Doctors Say: No New Medicare Patients
By John R. Graham Filed under Medicare on December 1, 2015
If you learned that 93 percent of non-pediatric primary care
physicians took Medicare patients and 94 percent took
patients with private insurance, you would likely conclude
that Medicare is doing just fine.
Unfortunately, such data do not describe physicians
behavior at the margin, which is what will determine future
access to Medicare. The Kaiser Family
Foundation/Commonwealth Fund 2015 National Survey of Primary
Care Providers also asks which physicians are not accepting
new patients: 21 percent are not taking new Medicare
patients and 14 percent are not taking new privately insured
patients. That is, the proportion not taking new Medicare
patients is 1.5 times greater than the proportion not taking
new privately insured patients.
I would encourage the Kaiser Family Foundation and
Commonwealth Fund to add a little more detail to the survey,
by breaking Medicare down into traditional Fee-For-Service
(in which physicians are paid according to a fee schedule
dictated by government) or Medicare Advantage (in which they
are paid fees negotiated with private insurers), and by
breaking privately insured into categories (especially
patients on Obamacare exchanges).
It would also be interesting to learn whether the physicians
who are saying enough to new Medicare patients are more
likely to be in new payment models (Accountable Care
Organizations) which frustrate them. (Another survey reports
a wide dispersion of opinions about such reforms among
Nevertheless, even this level of detail indicates baby
boomers aging in to Medicare will have increasingly
difficult access to care. The idea of premium support
(whereby Medicare beneficiaries receive subsidies to choose
lightly regulated private plans), which NCPA advocates,
should become more politically acceptable if not
Many people would rather die
than think; in fact, most do.
-- Bertrand Russell