I had an MRI today...

[CaliforniaPeggy]

Since I became eligible for Medicare, I've used it a lot. It's been great.

But I have to say I'm worried, since I'm hearing that every year, Medicare pays the doctors who accept Medicare patients less and less...

Some doctors have even opted out of accepting Medicare patients.

What's going to happen to these patients?

I'm so glad it's there for me...I want it to continue, and to be there for everyone...

[GitRDun]

1. You have just described the long term issue we face in medicine from a cost perspective

There are lots of things that can be done but the lobbies need to be shoved around enough to do them.

[CaliforniaPeggy]

4. You could very well be right...

[GitRDun]

24. Here is just one small issue from today...

Cape Cod Times
By Cynthia Mccormick
November 14, 2008

New state regulations specify that physician-owned day surgery centers will undergo the same review process as hospitals seeking to expand their services.

Regulations passed this week by the state's Public Health Council say physician-run surgery centers have to prove their services won't duplicate or threaten existing programs.

A Cape Cod Healthcare official said that's a good thing, but a hospital lobbyist said the new regulations may be too late to help Cape Cod hospitals competing against lower-cost physician-owned surgery centers.

"These tighter regulations make sense," said David Reilly, spokesman for Cape Cod Healthcare, the parent company of Cape Cod and Falmouth hospitals. "We're in favor of anything that would level the playing field."

The new regulations say physician-run surgery centers have to meet the same guidelines as hospitals, which are required to be open 24 hours a day and cannot deny care based on inability to pay, Reilly said.

Officials at Cape Cod Healthcare have been saying that ambulatory surgery centers run by physicians have siphoned off patients, cut into hospital profits and contributed to the fiscal crisis that led the organization to lay off 169 employees this summer.

So outpatient is cheaper, but hospitals fight like crazy to keep these surgery centers from growing in their areas because it eats into there profits. The politicians are helping the hospitals (thanks to the lobbyists) by including duplication regs, EVEN THO hospital based costs are higher!

All of these healthcare issues involve businesses fighting for their very survival in a quickly changing world. We need serious politicians who are not on the take to work through these issues, or it is going to get VERY PAINFUL for all of us. A quick read of this article tells us exactly why it is so damned hard to lower costs.

[spanone]

2. i worry for my children....both in their 30's.....

[CaliforniaPeggy]

5. As I do about mine....in their forties...not to mention my grandchildren ...

[Sekhmets Daughter]

32. So are mine....

We had better have single-payer, universal care by then!

[spanone]

50. i hope it will evolve into that...i believe it will....

[likesmountains 52]

3. I also worry that there are fewer physicians going into Family Practice.

They work so hard and their reimbursement is so small. I work in a hospital and most of the med students that rotate through are opting to be Emergency Room docs...no office, no overhead, decent pay. It's really sad.

[CaliforniaPeggy]

6. It's not a glamorous position at all.

I actually have a family practice doc, and he's great. VERY knowledgeable and a great guy as well.

[Blue_In_AK]

7. In Alaska very few general practice doctors take new Medicare patients.

They've had to open two new clinics in Anchorage specifically for the older folk, I.e., us.

[CaliforniaPeggy]

9. That is a tough situation, my dear Blue...

I hope you'll get good consistent care with the clinics.

[Liberal_in_LA]

8. out of pocket = zillion dollars

[CaliforniaPeggy]

11. Not sure I'm following you here...

Do you mean our out of pocket will = a zillion dollars?

[Liberal_in_LA]

17. no, I mean an MRI is a zillion dollars for those without insurance. Glad you have medicare.

[CaliforniaPeggy]

18. Oh, OK, thanks!

I can't even imagine how much an MRI would cost on a cash basis!

[Mika]

19. Actually, self pay can be less expensive than the insurance billing code

MRI centers like self payers because they get paid right away, and so they can charge less, and many do.

The insurance billing code for my recent MRI was $1600, the self pay fee was $375.

[Liberal_in_LA]

25. true. I had blood drawn in prep for surgery. Cost on bill was $2000. Insurance knocked that WAAAY

Down before they paid.

[Ms. Toad]

40. That is extremely rare.

I have no experience with MRIs, specifically, but considerable experience with other care. It is much more typical for self-pay individuals to be charged considerably more, because they have to makeup for negotiated discounts with insurance providers and (generally 10-20% more for physicians, for labs the self-pay is 5-10 times what insurance pays) and for charity care.

[Sgent]

48. Not usually

self pay *might* get discounted rates down to what the better insurance companies pay -- but not much more than that unless its a physician performing charity work or RHC / FQHC (clinic) which provides a sliding fee.

Also, self pay patients usually have to pay up front, which maybe affordable for a physician visit, but may cause real problems for surgeries and similar issues.

[lalalu]

10. Medicaid not Medicare.

There is a big difference between the two. Many doctors do not accept Medicaid and more have opted out. I do not know one single doctor who has said they will no longer accept Medicare. All my doctors accept private insurance and Medicare but not Medicaid. I would not worry or believe the hype.

As to the MRI it has been one of the best inventions. I had my first one back in the late eighties and fell asleep inside
I was originally just told I had a degenerative disease . I have one about every two years and the MRI helped to narrow it down to Multiple Sclerosis. This allowed me to get the right treatment and decrease attacks. Good luck to you and I hope your news is good news.

[CaliforniaPeggy]

13. My husband has been keeping track of this, and he said it's true about Medicare.

None of our doctors have opted out, thank goodness!

I have not been keeping up with Medicaid.

My MRI was of my right shoulder, to see what shape my rotator cuff is in. I'm getting that shoulder replaced in January, and it's important for my doc to see how my rotator cuff is.

Good for you, falling asleep! I do OK, but I could never do that!

[anneboleyn]

37. There are several doctors in our area (IN) who do not accept new Medicare patients (or Medicaid).

In fact most of the new patients have to go to a physician located out of our local area (about an hour away).

[lalalu]

57. That is very strange. I live in New Jersey and

no such problem exists in the metro area. It could be a political issue and based on where you live. In my area the doctors and hospitals gladly accept Medicare but not Medicaid and we have some of the top doctors.

[MineralMan]

64. It all depends on the area. In metro areas, where there are plenty of

multi-specialty clinics, you'll find that they all accept Medicare. In places where most primary care is done by physicians in individual private practices, that may not be the case. I haven't been a doctor in an individual private practice for years, now. Most also were not in-system for my Blue Cross insurance, either. However, there are multiple large clinical practices within a 15 minute drive of me here in the Twin Cities. Same-day appointments and Medicare acceptance is standard in those. I have an individual internal medicine doctor as my primary physician, and I chose him myself. He is in a group practice at a very good multi-specialty clinic. If I need to see a neurologist, for example, there's one in the same building and the same practice.

Medicaid is something altogether different. Fewer clinics accept medicaid here.

[lalalu]

65. That makes sense and explains the differences.

[Honeycombe8]

12. I'm concerned, too. I'm in my late 50's. Health care cost is the single biggest issue facing me

in my retirement years.

[CaliforniaPeggy]

15. I hear you, my dear Honeycombe8...

I hope things will be in better shape for you when you retire.

[dhol82]

14. worry about doc pay

just have to say that when i see how little my docs are paid i worry about the future of medicare. just got on last year and it is phenomenal! have heard that the powers that be want to decrease reimbursement. that would be tragic. lower reimbursement would mean fewer docs agreeing to accept the medicare patients. not good.

[CaliforniaPeggy]

16. That is my concern too.

Welcome to DU, dhol82!

I'm glad you found us...

[Sekhmets Daughter]

20. In CA?

There are doctors here in FL who only take Medicare patients....And live in subdivisions in which each and every house has it's own airplane hangar and runway! My late honey's primary care physician was one such. I'll be 65 in Feb. I'm thinking of just taking the Part A as I am disgustingly healthy....donate blood regularly so I know my blood pressure and cholesterol are good as is my sugar.

Hope you get a good report from your MRI.

[CaliforniaPeggy]

22. Yes, in CA!

Good for you!

I'm glad your health is really good too...

Still, you might want to think about Part B...

[Sekhmets Daughter]

31. Just very fortunate...

I'm thinking about it...everyone and his brother is sending me info. I'm surprised doctors in CA are doing that. But you know, those are not doctors you would want to see anyhow. They don't give a rat's ass about their patients, just their billings. We really need a complete overhaul of the entire health care profession, not just the insurers.

[HipChick]

21. Hands off my Medicare...

ok..well...I have more than a few years to work yet, but still...It better be there for me, when I am ready..

[CaliforniaPeggy]

23. I hope it's there for you too, my dear HipChick!

It had better be!

[Liberal_in_LA]

26. Paul Ryan wants you to have a $7k voucher, which you'll use to purchase awesome insurance

[HipChick]

35. Ryan can go...

'eff himself...

[fadedrose]

27. If the drs are in a high unemployment area where healthcare has

all but disappeared from the "middle class" - they're less fussy about accepting Medicare. It's either Medicare or no paying patients...

[CaliforniaPeggy]

28. I don't think that's the situation here...

It's a pretty affluent area. I don't think we have much in the way of unemployment.

But I believe what you say about areas of high unemployment!

[glacierbay]

29. Are you OK?

Why did you have and MRI? I hope everything is OK.
My medical plan with the SLPD is pretty darn good, I pay very little out of pocket for medical and dental, vision is decent. When I retire, my benefits will be pretty generous.
I believe that Pres. Obama needs to push, and push hard for single payer, medicare for all, that should be a major goal for him.

[CaliforniaPeggy]

36. My dear glacierbay...

I'm OK, but my right shoulder is CRAP.

Two big spurs and no cartilage=pain, and lots of it.

So, my shoulder will be replaced in January...

I'm glad your benefits are so good!

[glacierbay]

38. I'm glad you're ok

I had my left shoulder dislocated by a suspect I was arresting and I'll say that is the worse pain I've ever had.
I sincerely hope it all works out for you and keep us informed.

[CaliforniaPeggy]

42. Ouch! That had to hurt.

I will keep you informed...I'm a talker!

Thank you...

[w8liftinglady]

41. Oh,man. I wish I were closer... I'd take good care of you.

Let me know if you need anything.
Hugs

[CaliforniaPeggy]

44. Thank you so much!

I expect to do well, and not have it be as serious as my knee replacement was earlier this year.

My husband will be here to do what little I may need...

[fadedrose]

43. Both my shoulders are crap..

Didn't know shoulders could be replaced.

Last few days (actually months) I wake in pain, hard to type and even harder to read books (which I love), and I tell the "weed" that I think I may have a heart attack today, nothing better to do, and I'm ready....

Keep us informed on the shoulder. Besides being concerned about you, there are many of us in the same or similar predicament and don't realize how many of us there are.

Love ya Peg...

and God Bless Medicare!~

[CaliforniaPeggy]

45. I'm sorry to hear that.

My right one is bad too, just not as bad as my left...

You might want to have an orthopedic doc look at you. Apparently these surgeries are a lot simpler and easier to recover from than in the old days...

My doc says not only will the pain be gone, but I'll get back quite a lot of my range of motion.....something I'm looking forward to!

[fadedrose]

47. You mean I'll be able to throw a discus?

Amazing. I never threw one before...

nighty-nite pegs

[Odin2005]

59. OWWWWW! Hope they get that fixed!

[CaliforniaPeggy]

62. They can fix it, and they will!

The spurs will come out along with the joint itself, and they'll (I think) glue in a new joint. It takes about an hour.

Not to worry, my dear Odin2005!

[Mme. Defarge]

30. I dunno ...

There are so many of us geezers that I can't see how a majority of doctors would choose to ignore this market.

[NightWatcher]

33. I go to Dr's that work in the hospital system where they treated me as a "charity case"

It's also pretty cool that all the Dr's are plugged into the system, so they have my records on file with each other. The hospital helped me file for Medicaid which covered everything that they couldnt write off. I've found that the religious hospitals are more likely to write off portions as charity.

[HeiressofBickworth]

34. I posted this on another thread; it applies to this one, too.

My primary care-giver is a small neighborhood clinic. When I turned 65, I was told that because I was a long-term patient, I would continue to receive care under Medicare but that the clinic is not taking new Medicare patients. Ok, so this worked out for me. But what if I had to move to another location? If ALL doctors refused to take new Medicare patients, I would have no doctor at all just like Medicare patients moving to THIS area will be refused service.

I see the plot developing thusly: Make cuts to providers who then won't see Medicare patients. When the majority of Medicare patients are without doctors or hospitals, complain loudly how Medicare "doesn't work". After proving how Medicare "doesn't work", cancel the entire program. The right-wingers failed to privatize the system and have consistently failed to destroy the system, so they will achieve the same results by cutting the foundation out from under the patients. Rich Republicans will not rest until seniors die and get out of the way. They disgust me to my core.

[w8liftinglady]

39. fortunately,in 2013-2014 reimbursement for Family Practice docs will increase.

http://www.acponline.org/advocacy/where_we_stand/access/internists_guide/v1-enhanced-medicaid-reimbursement-rates.pdf
http://dhhs.nv.gov/HealthCare/Docs/policypapers/Section1202-PaymentstoPCPs.pdf

Unless,of course, Republicans do something awful.

What we need to work on is College reimbursement in exchange for years of service.

[WillyT]

46. You Better Be OK...

Don't think I cold live without you.

You stay well...

[CaliforniaPeggy]

52. Aw......my dear WillyT...

I hope to have many more years ahead of me...

Don't you go worrying now...

I'm OK, I truly am. Just some lousy joints is all.

[WillyT]

53. I Pass To You... A Better Joint...

[CaliforniaPeggy]

54. Omigod! I'd probably be high for a week!

*Groan* A better joint......

[Blue_In_AK]

55. Hey, pass that over here, WillyT

I can take it.

[nahant]

49. MRI you worry about what is in the contrast they infused you with...

be very careful of what you allow the radiologist to put into your body! There are life changing implications..: http://www.acr.org/SecondaryMainMenuCategories/quality_safety/contrast_manual/FullManual.aspx

http://www.acr.org/SecondaryMainMenuCategories/quality_safety/contrast_manual/FullManual.aspx
There is a lot more info if you look.. Gadolinium is toxic!! And GE & Bayer are trying to obscure the truth..

[CaliforniaPeggy]

51. Nothing was infused into me...

I lay in a tube for a while, and it did its thing.

I've had three MRI's now, and never had anything infused. No contrast stuff was needed for me.

[lunasun]

56. +1

[Odin2005]

60. WOO ALERT! WOO ALERT!

[MineralMan]

66. Why would they use any contrast medium in a shoulder

MRI? Please don't post about stuff you don't know about, especially when it comes to medical issues. Further, both of the links in your post go nowhere but to a 404 error. Finally, what you reference is pretty much nonsense. Thanks for being more responsible in your future posts.

[Odin2005]

58. I'm on Minnesota's state coverage for the disabled...

...and I have a hour's drive to get to the nearest dentist who will take Minnesota Medical Assistance, it drives me crazy!

[cherish44]

61. I had a brain MRI last week

Dizzy spells....I needed a sedative...freaked out after about a minute with that loud noise! Was able to complete the test after they gave me an Ativan but I hope I never have to get another one again! (And my insurance BETTER pay for it; I pay the damn premiums 100% out of my own pocket, my employer doesn't offer insurance). Hope is well for you Peggy ((hugs))

[CaliforniaPeggy]

63. They should have warned you about the noise!

I got headphones and some music to help me, and it did help.

I've had three now, and they do get easier.....