[lit-ideas] Re: health care in the US
- From: JimKandJulieB@xxxxxxx
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Mon, 30 Jan 2006 23:26:51 EST
<<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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