While the rest of the country’s physicians have been fighting to keep their financial heads above water due in part to Medicare reimbursement issues, their colleagues in the northernmost state have been enjoying a rare display of Federal largesse.
Showing the power that politicians have, Alaska’s physicians actually were the beneficiaries of a $53 million increase in Medicare reimbursement over the last two years. Engineered by powerful Sen Ted Stevens (R), the program ran for 2004 and 2005, before ending at the end of last year. According to news reports, the idea was to see if the increased reimbursement would lead more docs to accept Medicare patients.
The Anchorage Daily News notes the impact on reimbursement is significant:
“The office charges $133 for a 20- to 30-minute office visit with a regular patient. Blue Cross Blue Shield and Aetna — both preferred insurance providers for the clinic — cover about $113 of the $133, Warner said. Medicaid, the government insurance program for people with low incomes, pays $77.61.
Starting in 2006, Medicare will pay the least of all. While the extra money was available, Medicare would cover $87.97 of $133, or 66 percent. Now that the money is gone, Medicare will pay $53.30 for the same visit, or only 40 percent, Warner said. The federal government allows patients to make up some of the difference but not all of it. ”
Perhaps the providers would have liked to trade a continued subsidy for a couple of bridges to nowhere. These bridges, both in Alaska, have been widely seen as evidence of Congress’ predilection to spend money on projects that benefit their own constituents at the cost of others’. The much-derided bridge project would have funded the subsidy for about eight more years.
Jan
4
This story is indicative of part of the problem we face in healthcare “insurance” today. The insured patient, who for years has been sheltered from the real cost of health care, has a $20.00 co-pay, and so they think a doctor’s visit costs $20.00.
The doctor, who for years has been sheltered from actual market forces (i.e., what a consumer is willing to pay for an office visit) charges $133.00 for the office visit.
The federal government, relying on impressive sounding, but likely irrelevant statistics, sets an artificial price that it is willing to pay for that office visit, sometimes dropping the medicaid/medicare patient right out of being able to access care.
So what is the actual cost of an office visit? Should it be the same if the nurse practitioner really does most of the work? Will patients skip doctor’s visits that are necessary if they have to absorb more of the payment?
It’s time to start over. What do we want from our healthcare system, and how can we achieve that effectively and at a reasonable cost, while still preserving as much individual freedom as possible?
Tough questions and, no doubt, tough answers, but there is a unique “American Way” out there and we need to find it!
Perhaps it would be better if a few members of the family of the exalted Ted “bridges and oil wells” Stephens had bought land to be turned into medical office buildings, instead of the land they did own next to the airport to be connected by the famous bridge.
Alaskan politics is easily explained by corruption, and this smacks as being no different.