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I am not a doctor but I am a pharmacy technician and we deal with Medicare and Medicaid on a daily basis. I'm sure that the doctors have many of the same problems we have: 1) Reimbursement takes months at time. I work for a major chain so it's not a problem for us to wait. For a private business, those 3 months can mean the difference between staying in business or closing up shop. Imagine if you have 10 Medicare patients each month all being billed at $100 (this is just for round numbers). Month 1: you are behind $1000. Month 2: You are behind $2000, Month 3 and on: you are behind $3000. This is only for a single visit. Often times it's families or multiple visits. Those numbers can easily triple. Running a private business $10,000 in the hole month to month is not going to let you stay afloat long. During this time, you need to get a loan to cover expenses. So if your loan is at 6% (a low rate), that means you are behind even further because you are now paying a bill that you should never have had in the first place. 2) The government does not want to cover certain expenses. I understand that some treatments cost more. I don't think they should pay for experimental treatments. However, they should cover most other treatments. Instead, at least for us at the pharmacy, we have to request an authorization. This can take anywhere from 1-14 days. We aren't told whether or not it's approved. We just get to keep trying. The time I spend trying to get an authorization and talking to the patient and doctor about it, is time I could spend helping another patient or two every day. I'm a a slow pharmacy and we do about 2-3 prior authorization requests every day. 3) Only some doctors are contracted with Medicaid. This means that if the doctor is on vacation and his partner writes the prescription, it might not be covered because the second doctor may not be contracted with Medicaid. Now the patient can't get his heart medication. I am spending 30+ minutes trying to find a doctor that will write the prescription. This is costing me time, my company money, and the patient too much grief. All because his doctor decided that he wanted a week off to spend with his family, like he deserves. 4) Medicaid and Medicare are notoriously difficult to contact if there are any problems or concerns. I routinely wait on hold for more than 90 minutes to contact Medicaid. This is not an exaggeration. Sometimes the queue is so long that the computer just tells me to call back and then hangs up on me. 5) In the state I live in (I am sure there are others with this same issue), the patient cannot legally forgo using Medicaid. So if a patient comes to us in the pharmacy and the prescription would cost $4 but Medicaid wants an authorization, I cannot sell the prescription at $4. I must attempt the authorization. Do you know how much fun it is to tell a mother that I cannot sell her the $4 antibiotic for her screaming son? The programs do a lot of good and have helped many people. They need to be revamped to be better. Using these should not put private businesses out and should not require hours of time for such a small number of people using them.
It just doesn't make the payments on their condos or Mercedes.What they hate most is all the paper work they must go through to get payed.Plus the low reimbursement they receive.Here's a good example of why the doctors and health companies don't want government to get in their business.I get my medications from the VA.They bargain with the drug companies on the cost of drugs they receive and pass the saving on to the patient.The other day I was running low on one of my drugs and didn't get my order in on time from the VA. I ordered on my back up plan which is a standard health secondary plan.The drug from my health plan was $45.00 dollars.The same drug from the Muscle Shoals is less then $10.00 They,the VA, are not subsidized by the US government on the cost of their drugs. The doctors, insurance companies, and the drug companies, are bed partners and until we have them separated we will continue to see cost going up.
They fix prices for services. Many doctors refuse Medicare/Aid patients, preferring people and insurance that pay full price. They know as the government takes over more and more of healthcare, they can never recoup the high costs of their education and internships, so they move on to other careers. This is why you see so many foreign nationals in our health care now, they didn't pay so much for their Bangalore education.
Because they do not like regulation. They prefer to charge you $120 for the 10 minutes they spend looking at you. And medicare and medicare have a cap on what they can charge. And they are required to do preventive medicine to keep down costs. Of course it could also save your life.
There's a lot of waste,not from the doctors but from the companys supplying products
It's probably takes more effort to get paid through those programs. Unlike an HMO.
Because they are the Government. Their leaders set the prices for everything.
They save the medical industry millions by not having to chase down bad debts.
The hassle of getting paid by them.
They may say so, but it provides a guarrantied source of patients and income.