Doctors' Lunch

One doctor described the losses he and his office associates will incur under the 21% professional fee reduction that the Medicare law has put into place. In this recession, they will have to cut staff, cut services to those who cannot afford to pay them (the federal government has just cost-shifted its reduction to the full-pay population, but perhaps you had not noticed) and are entertaining the question of how to reduce the number of Medicare patients who now take up office space and time but don't bring in the revenue to pay office bills. All of the doctors seemed bothered by the American Medical Association's inability, or unwillingness, to represent their professional interests and one astute observer noted that the Association has long outlived the purpose for which it was founded and seems much more interested in perpetuating itself and its bureaurocracy now. One of the few people at the table who still is an AMA member declared his intention to quit the organization, which was not a surprise to the others who had made that decision some time ago.

None of the doctors believed that the health insurance industry would provide payment for the care that sick people need and they shared their experiences of hearing patients tell them that they could not longer afford health insurance because they were being priced out of the market, a problem not resolved by current health care reform legislation.  There was cynicism about the insurers underwriting practices which would make insurance available to the sick, but at an unaffordable cost.

What were the doctors in favor of? All seemed to support a single payer system and there was hope that the current health reform is a transition to that system. The single payer system takes inefficiencies perpetuated by insurance companies out of the system and uses dollars to pay for care, not executive suites and unconscionable administrative overhead (link requires Medscape password which few readers may have).