Sunday, October 4, 2009

Magical Medicaid

I know that many liberals think that the answer to healthcare accesss is government plans. I actually had one in the office on Friday. He was mad that it took so long to get an appointment. As usual I claimed responsibility for the delay, said I was sorry and took care of him. He muttered that he had insurance (Medicaid) so he should have had to wait. This is what I really wanted to tell him.

All of us physicians have templates. These are the schedules that allow us to schedule patients. Right now, if a patient has Blue Cross we get paid three to four times as much as someone who has Medicaid. In fact, a patient who pays $40 out of pocket is paying us twice as much as someone who has Medicaid. If we want to maximise our payments we would see only Blue Cross, if we could not fill our schedule we would see lower reimbursed insured, we would then add self pay, and then if there are any openings left, we would see Medicaid. So, every physician has to decide if they are going to see any Medicaid at all. Since it pays worst of any other insurance if you do take it you put them to the back of the list. I hate to say it but Medicare is just infront of Medicaid. So, if you are going to take government insurance, those patients will be at the back of your waiting list. Our group has decided that it wants to help everyone as best as we can regardless, that being said, we still have to stay in business so we have placed in stone some Medicaid appointments in everyones schedule. I have to admit though, you will wait alot less if you have good insurance.

So, what is going to happen with this government option? It is going to put even more people at the bottom of the list. Face it, if you pay cash, you will get in sooner. This whole thing about preventive care? Medicaid pays $19 dollars for a 30 minute preventative care visit. Blue Cross pays five times that amount. If you are already full, why would you take less money and incur more liability to do preventative visits that aren't worth the money? Of course, there is no medical liability in the healthcare bill either!


SeaSpray said...

Hi Throckmorton - I've never worked in a physician's office and so have never thought much about scheduling protocols. Interesting.

I think it is admirable that you do take MDCD pts.

My mother's main doc took her on even tho she had mdcd and my gyne doc took her when she only had mdcr and never charged her after the mdcr and then when she got mdcd..he accepted that.. which I guess at least gave him more then writing off the rest after mdcr.

I always appreciated their kindness with her.

I didn't realize mdcr was that bad tho. I know they are a pain with denying payments if you don't dot every i and cross every t. (Hospital drilled that into us)

If I had the best insurance or none at all.. I could not imagine ever being mad at my doctors. Well.. if it was serious.. but then go to ER.

I just hope we don't ever go down that road where people die of cancer because they had to wait too long to have the surgery for the diagnosed cancer, etc.

Even worse...try to find a mdcd dentist. We would have repeat ER pts with dental problems coming in. Some drug seeking.. but some genuinely have problems but can't afford treatment.

You make valid usual. :)

SeaSpray said...

Ha ha! and EWW!

Throckmorton..I just have to tell you that I went to WC's blog just before going to bed last night and saw that I missed your link to Bot flies.

When I first saw your question to WC, I immediately googled Bot fly and came across a very clear video of a guy who must've had several in him and I watched them take 2 from the same opening. It was interesting... but ugh! (Stomach feeling flippy just recalling it)His friends helped him. Think they were biologists.

but then later I looked at your link and I made the mistake of looking at other than just the bot fly. i thought the ear wax was some resistant creature in the ear. Totally gross.

It's not so much the body things.. it's the gross, slimy, squirmy living things in the person.

Anyway... I ended up having a bunch of dreams in sequence of bugs crawling out of humans and open wounds. I don't ever recall having dreams like that.

LOL! Not the kind of videos one should watch before bed!

Tonight..I'll counter them with a comedy! :)