[lit-ideas] Re: health care in the US

 
<<When  I am really sick, I describe symptoms to receptionist and they call 
in a  prescription to the local pharmacy.  (this is only for non-chronic  
conditions.) >> 
What an indulgence!!  No Doctor  here will do a script w/out an office visit. 
 You can be laid flat by strep  throat (which I have been this week), and 
manage to get yourself to the Dr's  office; often the wait for an appointment 
is 
ridiculous; if you don't show up  with insurance or cash in hand they won't 
see you.  It's roughly $80 for an  office visit.  And then you drag your 
fevered 
body to the pharmacy to cough  up the $150 for the antibiotic.  My Dr. (now 
all Dr's) will not even call  in a birth control script without an office visit 
to keep their billing  up.  I do understand it at one end -- my husband does 
DME stuff --  respiratory therapy -- oxygen concentrators and tanks, takes 
care of people with  lung diseases, etc.  In the last 10 years there has been 
no 
increase in  what Medicare will pay.  Obviously the durable medical companies 
have keept  raising their prices for their goods.   
The whole situation is  untenable. 
Julie Krueger 




========Original  Message========     Subj: [lit-ideas] Re: health care in 
the US  Date: 1/30/06 10:17:36 PM Central Standard Time  From: 
_vcaley@xxxxxxxxxxxxxx (mailto:vcaley@xxxxxxxxxxxxx)   To: 
_lit-ideas@xxxxxxxxxxxxxx 
(mailto:lit-ideas@xxxxxxxxxxxxx)   Sent on:    
This sure is right.  All my physicians are specialists.   My internist is the 
primary care person.  I go into the office every three  months, talk about 
how I feel and doc listens to my heart and lungs, renews  medications.  When I 
am really sick, I describe symptoms to receptionist  and they call in a 
prescription to the local pharmacy.  (this is only for  non-chronic 
conditions.)  If 
it sounds serious, one is directed to the  emergency room, which is over 
loaded with people who have no insurance and it's  a thousand dollars to step 
through the door.  And we have the best  coverage.  The whole system is nuts.  
Why 
go to a doctor if one does  not feel sick and the chronic condition is 
controlled but not eliminated?   To keep to a good schedule for a doctor I 
guess.
 
Veronica Caley
Milford, MI
 

 

----- Original Message ----- 
From:   (mailto:JimKandJulieB@xxxxxxx) 
To: _lit-ideas@xxxxxxxxxxxxxx (mailto:lit-ideas@xxxxxxxxxxxxx) 
Sent: 1/30/2006 11:04:03 PM 
Subject: [lit-ideas] health care in the  US


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Primary care about to collapse, physicians warn 
 
 
 
By Maggie Fox, Health and Science CorrespondentMon Jan 30, 1:44 PM ET  


Primary care -- the basic medical care that people get when they visit  their 
doctors for routine physicals and minor problems -- could fall apart in  the 
United States without immediate reforms, the American College of  Physicians 
said on Monday. 
"Primary care is on the verge of collapse," said the organization, a  
professional group which certifies internists, in a statement. "Very few young  
physicians are going into primary care and those already in practice are under  
such stress that they are looking for an exit strategy." 
Dropping incomes coupled with difficulties in juggling patients, soaring  
bills and policies from insurers that encourage rushed office visits all mean  
that more primary care doctors are retiring than are graduating from medical  
school, the ACP said in its report. 
The group has proposed a solution -- calling on federal policymakers to  
approve new ways of paying doctors that would put primary care doctors in  
charge 
of organizing a patient's care and giving patients more responsibility  for 
monitoring their own health and scheduling regular visits. 
U.S. doctors have long complained that reimbursement policies of both  
Medicare and private insurers reward a "just-in-time" approach, instead of  
preventive care that would save money and keep patients healthier. 
"Medicare will pay tens of thousands of dollars ... for a limb amputation  on 
a diabetic patient, but virtually nothing to the primary care physician for  
keeping the patient's diabetes under control," said Bob Doherty, senior vice  
president for the 
ACP. 
The ACP plan called for innovations such as using e-mail to consult on  minor 
and routine matters, freeing up expensive office visit time for when it  is 
needed. Doctors would be compensated for an e-mail consultation. 
The proposals include incentives for doctors to work more efficiently and  to 
provide better care, ACP President Dr. C. Anderson Hedberg told a news  
conference. "ACP proposals would provide patients with access to care that is  
coordinated by their own personal physician," Hedberg said. 
YOUNG DOCTORS AVOIDING PRIMARY CARE 
The ACP cited an American Medical Association survey that found 35 percent  
of all physicians nationwide are over the age of 55 and will soon retire. 
In 2003, only 27 percent of third year internal medicine residents actually  
planned to practice internal medicine, the group said, with others planning to 
 go into more lucrative specialty jobs. 
"Primary care physicians -- the bedrock of medical care for today and the  
future -- are at the bottom of the list of all medical specialties in median  
income compensation," the ACP said. 
The group, which represents 119,000 doctors and medical students in general  
internal medicine and subspecialties, joins others that warn the U.S. health  
care system is untenable. 
"If these reforms do not take place, within a few years there will not be  
enough primary care physicians to take care of an aging population with  
increasing incidences of chronic diseases," said Dr. Vineet Arora, chair of  
the 
College's Council of Associates. 
Dr. Sara Walker, a Missouri physician, said she believed doctors were  
leaving general practice because of drops in Medicare reimbursement to  
doctors. 
"A drop in Medicare payments will not only force me to stop taking Medicare  
patients but could force me out of business," agreed Dr. Kevin Lutz, a solo  
practitioner in Denver.  






 
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