My PROPOSAL is that DOCTORS AGREE TO SINGLE PAYER, in exchange for unionization and collective bargaining.
This is a brilliant statement putting it all down in a nutshell. I hate to act like there is one problem, but ONE of the huge problems is ignorance. (I don't mean the term in an arrogant way). I have over 60% Mainecare and am the largest pediatric solo provider of Mainecare in Maine except for the FQHC who makes three times as much. I don't bring it up, but when it comes up in discussion, my Mainecare patients are completely flummoxed (as George would say) what the reimbursement is. They also cannot believe that the FQHC makes nearly $100 for the same patient visit I get $27.00 for.
Meanwhile we have a Preferred Drug List, which means I have to struggle to get a CP patient with a trach glycopyrolate or Xopenex for a congenital heart patient. Yet, my three patients with Mainecare can go to the ED at 2PM, because it was closer to their house. I also can charge the allowable charge for record transfers for all self pays and privately insured, but I cannot for Mainecare.
There was a group of OB/Gyn in New York area who tried to fight the insurance companies and the Assistant Attorney General struck it down in court and then went on to say, "I have saved the consumers from the greedy physicians."
I think the problem I alluded to above is that the American people (I know that sounds cliche, but it is true) have no idea how the insurance system works and especially the socialized part of it. They don't know how the ED sees patients for colds and flu when they should be seen much cheaper. They don't know that the system works with privately insured, because there is a $100 copay at the ED and a $20 copay at the physician's office. All they know is that medical expenses keep spiraling upwards but not why.
The key is for awareness. The country moved forward because Martin Luther King brought awareness to the issue of illegal and immoral segregation. More awareness was shown due to the million man march. And, part of getting out of Vietnam was due to the many protests of the 60s. We have been in Iraq far too long, but how much longer would we be there if there were no media coverage.
I bet if you gave a 100 question test to all of the congress people in Washington, three of which questions would be what is the reimbursement for A) Anthem, B) Medicaid and C) Medicare; most would flunk miserably. And, ask them if Dr. X charges $110 per 99213 and Dr. Y charges $100 per 99213, who would make more money at the end of the day for ten 99213 visits. How many would get that right?
