Saturday, April 18, 2009

With more doctors not taking Medicare payments, why would government health insurance work for all of us?

As President Barack Obama pushes for a socialized medicine plan, I found this recent editorial by Dr. Marc Siegel, an internist and associate professor of medicine at the NYU Langone Medical Center of interest.

Writing in Friday's Wall Street Journal, Doctor Siegel noted: "Here's something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn't automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especial government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have."

Siegel noted that recent market survey conducted by the Medicare Payment Advisory Commission has shown 28-percent of Medicare beneficiaries looking for a primary care physician are having trouble finding a primary care physician. Here in Texas, according to a 2008 survey by the Texas Medical Association, only 38-percent of primary care doctors are now taking Medicare patients.

The problem, Siegel adds, is that the government requires an extensive amount of documentation to file a claim. And it's not just a government issue. Dr. Siegel noted that 11-percent of his colleagues at NYU Langone are not accepting Aetna or Blue Cross because of the administrative requirements and what he terms "diminishing reimbursements."

At my company, we help our clients understand the network of physicians that accept their private insurance plans. When needed, we also help our customers get through the morass of claims denials and processes.

However, I hope someone in Mr. Obama's administration sends Dr. Siegel's op-ed piece to him so he can question how the government will change the claims acceptance process that will help the medical community get the payment they deserve for treatment. If Mr. Obama truly wants to make a change in the health insurance industry, he must first clean up the administrative processes within his government.

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