Thursday, December 07, 2006

Medicare Premiums Increase, While Doctor's Payments Are Cut Back

It is a typical story in the business of insurance that often the premiums increase while the benefits are cut back. In other words, the insurance is less and less useful and affordable as time goes by.

That is what has been happening with the Medicare system. As politicians in Washington talk in a facile way about extending coverage to more people who don't have it now, the actions they actually do take are to make insurance more and more expensive, while the payouts are less and less satisfactory.

Now, I hear from my cardiologist that due to new schedules of payment he can probably expect 15% less in reimbursement for his work next year than he has been getting this year. And, he says, hospitals can also expect a decline in what they are paid by Medicare for the procedures they perform.

This development is unfair to the doctors and hospitals, but unfair to the patients too. As their premiums go up, their practitioners are given less and less for the work they do.

My own doctor, just for the record, is not a West Side physician, trying to charge outlandish prices for his services. His charges are, by comparison, quite reasonable. He works long hours as both a heart surgeon and a heart doctor, plus, in my case, he has been my primary doctor for many years.

I'm not saying by any means that he is suffering from poverty, but he usually accepts the reimbursement he gets from Medicare and medigap policies, and doesn't charge his patients any more. It is not fair to him that he is made to pay the brunt of the increasing costs of the medical system by accepting less and less in reimbursements.

In general, private insurers, the medigap companies, are being allowed, on the other hand, to reap greater profits. When the federal government adopted its drug prescription plan for seniors this year, for example, the powerful drug lobby managed to kill proposals that would have allowed the government to negotiate drug price cuts on a volume basis. Instead, what happened was that these profiteers, were allowed to continue to raise their prices far faster than the rate of inflation.

It is one thing to see that doctors and hospitals are paid just amounts for their services. It is another to allow private drug firms and medigap insurers to squeeze both patients and medical providers, year after year. The system is becoming unworkable.

I sympathized with what my doctor told me. He, and, in fact, all of us are being treated unfairly by politicians in Washington and the payment systems they continue to change and diminish.

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