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October 05, 2010

Must Read

On government medicine and compulsion:

In my life and work, when rules and regulations become overbearing and nonsensical, I tend to remove myself from the situation. For example, the rules governing Medicaid are so arcane that after a brief flirtation with the system, very early in my career, I dropped out of Medicaid. (The rules were such that filling out the insurance forms were annoying and the reimbursement for the first [and last] patient I ever saw under Medicaid took 18 months to finally arrive and required multiple iterations of forms first.) When HMO's and various insurance panels were first set up, I joined one panel. Here, too, the rules were arcane and more than a little annoying. I almost never filed the proper paperwork on time (my disinterest in paper work is deep and profound) and almost never got the proper pre-approvals; as a result I was only paid about 50% of the time for patients I saw for through the insurance panel. I dropped out after about a year. Finally, I dropped out of Medicare because of similar problems. If I submitted an insurance claim and my pen stroke extended beyond the lines, the form was summarily rejected, usually with no explanation. (I would start to wonder why I hadn't been paid and would call Medicare; after varied waiting times and multiple holds, I would finally be told my claim had been rejected and that I should resubmit. Sometimes this repeated more than once.) At the end I hired a billing service for my Medicare claims; they took 8% of the already reduced fee but at least I was able to get paid.

The Medicare system involves a fair number of rules designed to make it difficult for a Doctor to stay in the system or to leave. If a Physician sees a patient on Medicare and believes they need a certain type of treatment, Medicare can determine that their diagnosis and severity do not deserve as much treatment as might be offered. Further, they will not allow the Physician to privately contract for the additional services, even when the patient can afford it, nor will they allow him to see the patient at a higher frequency or intensity than they determine is warranted. This is the essence of a government run health care system. Once a Physician decides to leave the system, there are new impediments. While the Doctor may privately contract with his patients, his patients cannot then send the bills to Medicare for reimbursement (which would reimburse the patients at the Medicare schedule, not the billing fee.) In other words, if a patient cannot afford even a lower than Medicare fee, he cannot get reimbursed by Medicare for the privately contracted services. This stays in effect for two years from the time the Doctor leaves the system.

This kind of bureaucratic red tape is why so few doctors and dentists accept military patients. Dealing with TRYTOGETCARE is so cumbersome, slow and onerous that even doctors who are former military end up leaving the system in frustration.

Keep in mind that these are people who understand and empathize with military families. They want to treat military families.

Government cannot solve all problems or eliminate the structural costs associated with certain activities or choices. If you're looking for a good indicator of when government intervention is "too much", it's hard to argue with "when it makes doing business so hard that people who would otherwise be inclined to do provide a good or service give up in frustration".

Posted by Cassandra at October 5, 2010 02:02 PM

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Yet, under ObieCare, adding 18 million people to the system will magically make it work more efficiently -- almost as efficiently as TriCare, or the VA.

*staring deadpan at the screen*

Posted by: BillT at October 5, 2010 03:39 PM

O Mao Care heh.

Cause nobody else does.

The reason why the Left touts government healthcare for soldiers as a good thing is because they can cut their benefits and funnel money to their unions, bank bailouts, stock exchanges, and corporate masters.

If soldiers was covered by private care, it would be much more difficult to justify taking from them and giving to Islamic terrorists.

The Left likes to do things like that, however. It rocks their boat. Staying the course and all that.

Posted by: Ymarsakar at October 6, 2010 07:15 AM

I started reading this thinking it was written by a patient and thought, "Hey! I want to drop out, too!" At present the only way to opt out of of Medicare is to waive receipt of Social Security benefits. It's what I plan to do when the time comes, unless these idiots have made it impossible for me to retain my current coverage by that time. And I may do it anyway. They can all bite me.

Posted by: Texan99 at October 6, 2010 01:08 PM

They carry diseases, Tex. Stay safe now ; )

Posted by: Ymarsakar at October 7, 2010 05:09 PM