7/26/2010 9:58:00 PM Talk of the Town Column: Medicare Crisis, part 4; another viewpoint
By Larry Wonderling Special to the Courier
As I read the Courier's three-part Medicare Crisis articles with interest, I was reminded of a human perceptual paradox: We all tend to interpret the same event differently.
The entire series seemed critical of Medicare and recent health care reform, yet avoided any of the positive changes. Predominantly focused on the loss of income to physicians and other service providers, the series seemed disappointingly indifferent to the many benefits for Medicare patients and the eventual help to millions of uninsured.
The concerns of interviewed physicians seemed mainly focused on their own reduced financial prosperity with negligible regard for the welfare of Medicare recipients. In fact, the quoted physicians also appeared to proffer thinly veiled threats that if the government doesn't raise their fee schedules, they'll drop Medicare patients. These physicians conveniently tend to overlook the fact that hard-working citizens throughout the nation also are enduring an absence of raises, suffering through our recession's financial quagmire and experiencing losses of employment. Seniors on fixed incomes also are receiving no cost-of-living increases in their frugal Social Security income despite continued rises in medical care costs.
It's apparent that many people in our country are presently experiencing survival difficulties including loss of homes, rental evictions, etc, while most doctors, including physicians, may be experiencing a reduction in an elevated standard of living. This suggests that the vast majority of professional practitioners are experiencing a reduction in their profit margin, which is certainly a financial inconvenience but not a threat to their survival.
In times of financial crisis in our nation, I believe we should all be willing to endure financial sacrifices while helping, rather than threatening, each other.
A suggestion I have frequently heard, and also glaringly absent from the Medicare articles, is the redistribution of medical service providers. I believe that nurse practitioners and physician's assistants are well-trained to serve as primary care physicians. I have had both and, like most primary care physicians, they either treated my medical condition or referred me to a specialist.
Your typical primary care physician sees you for less than 15 minutes, after your half-hour or longer wait. There may also be a brief Q and A, occasional referrals to a specialist, and prescriptions. As a footnote, many studies in recent years clearly indicate physicians are overprescribing pain killers with resultant severe side effects, even death. Also, more than 70 percent of primary care physicians treat patients with expressed emotional problems, even though they are not qualified mental health professionals.
The point is that the excessive and uncontrolled cost of medical care in the U.S. desperately needs cost containment strategies, and one obvious solution is to encourage primary care physicians to seek more prosperous medical specialties. Then authorize less expensive nurse practitioners and physician's assistants to serve as primary care providers. Already, however, medical associations are warning that patients treated by such "non-doctors" would be in grave danger.
Nonsense.
Sometimes I think physicians, with one of the most powerful lobbies in Washington, believe they are the only indispensable doctors. Perhaps it's time to remind the AMA that dentists, chiropractors, veterinarians, optometrists, and even psychologists are also doctors as well as practitioners with at least as much education, and hard work, while providing critical services in any community.
As many physicians complain that a reduction in fees will reduce the quality of care for Medicare patients, I wonder why our medical costs remain one of the highest in the world, while the quality of our medical care ranks one of the lowest of all industrial nations. Also, why do private insurance profits in the U.S. consume 30 percent of health care costs, while Medicare overhead costs are about 2 percent? Once again, it is ironic that in our rich society we all seem to agree that we need to reform such programs as Medicare, provided it doesn't financially inconvenience us personally.
Larry Wonderling, Ph.D., is a retired California licensed clinical psychologist with more than 40 years of professional experience. Since his retirement, he has authored numerous professional articles and six books. In 2009, he was a winner in the prestigious San Francisco Book Festival.
Posted: Wednesday, July 28, 2010
Article comment by:
Seems to me .....
It seems to me that someone is bitter that they didn't get into medical school. Otherwise, it would be nice if someone who decided to take the time write this worthless piece to at least take the time to research his topic just a little.
Posted: Tuesday, July 27, 2010
Article comment by:
Get informed
First of all, let's not confuse the decrease in Medicare payments with the Health care bill. The reduction in Medicare payments is a problem that has been pushed off from previous administrations. The fact is that the House passed a measure to not decrease payments last November and then the bill was sent to the Senate. It took over 6 months in the Senate because of the bipartisan bickering to pass a temporary measure. The rate decrease is temporarily halted but only for 6 months. The real problem that needs to be addressed is the outdated Sustainable Growth Rate Formula that determines physican payment. This is unacceptable and no way to treat our seniors. The Republicans and Democrats need to get along and find solutions to this very important issue instead of the Republicans attacking the Health care bill.
Posted: Tuesday, July 27, 2010
Article comment by:
Tom Bowden
Thanks for your thoughts Larry, but I'll refer to MD's when it comes to medical care, not Ph.Ds. As for "nurse practitioners and physician's assistants", my suggestion to folks is to be careful. I had a "nurse practitioner" tell me that a spot on my chest was nothing, a month later it wasx diagnosed by a MD as cancer. It seems there is a reason to go to medical school. That was my experience, yours may vary.
Posted: Tuesday, July 27, 2010
Article comment by:
Truth Hurts
Gosh, two voices of reason in the same day. I thank the Courier for being a sound board for a discussion of vital events. Now let the wackos, haters and Constitutionalist have their way. Does "promote the general welfare" ring a bell?
Posted: Tuesday, July 27, 2010
Article comment by:
birther t. bagur
None of the whining doctors in the Courier's series would even say how much they made, or even how much income they derived from Medicare. In 2006 I lived in Wyoming and there was a ballot measure enacting tort reform up that year. Doctors were blanketing the state with stories of how they couldn't make a living anymore. At the exact same time, a doctor in Casper (the biggest city in WY) was building a gaudy 10,000 sf mansion right next to the highway through town. Everyone knew who was building that house, and I am convinced that is the reason that the tort reform law didn't pass.
