A Sense Of Entitlement

Dr. Donald F. Condon wrote an opinion piece which was printed in yesterday's Spokesman Review. He leads off with this:

"The primary problem with Medicare is simply this: Medicare doesn’t pay. Reimbursement for care is 35 to 50 cents on the dollar of charges submitted. This doesn’t cover overhead. It costs more to provide care for a Medicare patient than the reimbursement schedule pays.

Medicare constitutes 20 percent of my schedule, but since Medicare patients are, generally speaking, more complex, it often requires 30 percent of my time.

Medicare payments represent 5 percent of my income, so that means 25 percent of my day I am working for free. This busyness does not mean business is good. My practice population is aging and matriculating into Medicare coverage, threatening the viability of my practice."

He then continues on stating how bad Medicare is and supporting each declaration with what sounds like weak, selective support.

"Medicare is irresponsible and not held accountable: About two years ago Medicare prematurely launched a new computer program that was not ready to handle its own billing requirements. The consequence to my practice was that over $60,000 in charges was not paid for over six months."

Having been on both ends of the "computer program" spectrum--development and implementation--for 20 years, I have never seen a new "computer program" go in flawlessly.

Medicare interferes with the doctor-patient relationship: Medicare instructs patients to report physicians they feel may be overbilling. This is an unfair burden on the patient.

I'm sorry, but I just can't wrap my brain around that. If you tell a patient to report when a doctor is cheating the system you are interfering with their doctor-patient relationship? Do you mean the part where they're supposed to trust their doctor?

"I know of no other industry that is as mistreated as the health care industry. Government and military contract winners expect a profit, sometimes even large profits. Only the health care industry, charged with the health of the nation, is expected to subsidize the government."

So it's all about the money? Well, maybe not.

"Most of the physicians I know are generous and serving; that is why they are in health care."

What a wonderful sentiment. But at the beginning he said,

"I have worked with Medicare for 30 years, feeling I was doing my part. If ever there was such an obligation, it was paid back years ago."

So it must be all about the money.

"The Medicare system has taken advantage of the generosity of the physician for far too long. The current administration claims that physicians are paid too much and proposes to pay even less."

Is it unreasonable for him to expect what he thinks he is owed since he has obviously paid his dues?