Doctors dumping geezer patients

As Hook columnist Janis Jaquith predicted last month, doctors are dumping their elderly patients due to low reimbursements from Medicare, the federally funded eldercare program, according to a new survey.

Read more on: medicare


Why is everyone so angry? Its not healthy.

"which he inherited from Bush"


one of the answers is cited in the linked article:

ââ?¬Å?The health insurance reform law will increase reimbursement to primary-care docs by 10 percent.”

More money is the only answer to increasing elder care. The teabaggers can claim that militarizing the border with Mexico will do it, or imposing limits on litigation will do it (although a redress of grievances is enshrined in the constitution's very first amendment) or that allowing insurance companies to bybass state regulations will do it, but none of those proposals will result in increased care for the elderly.

The Obama health insurance reform law enacts a direct increase for primary care doctors. This will result in increased care for the elderly.

Those that claim to be for increased care for the elderly and then lambaste those that actually address the problem are in no way contributing to a constructive discussion.

Terry Teabagger:

If Obama were not raising our taxes though the roof, we could all afford healthcare!


Ah yes, yet the Teabaggers that can't come to terms with their own diametrically opposed beliefs, nor take responsibility for their own selfish actions.

It was amusing to hear the a Teabagger state that we needed to cut back, but it couldn't be their social security or the DOD, the only two things left to cut.

Where were the Tea Baggers when Tarp happened, or Bush invaded Iraq for no reason, or when we need to cut back on payments.

Suddenly the Tea Baggers found they couldn't find a big bill to spend on.

Throwing the blame back and forth is childish and pointless. All politicians take office under conditions they inherit. If they are not able to improve certain aspects under their control they risk loss of office. This commentary began on the issue of health care. Does anyone looking have any answers relative to the question?

no one read the article? wrote: "The connection between these policy proposals and senior citizens receiving better and more care seems tenuous, however."

A rising tide lifts all boats. Anything that benefits the medical system as a whole will benefit all groups using it.

Tim Browns got it nailed, "they be gamin the system" If Obama attempts to reduce the incredible subsidies to the health care companies who support medicare advantage etc... The health care companies will play their card which is basically scare the old folks.

we are already printing $ as fast as possible. But why give it to the MDs for service they will not provide? Disseminate info for self care instead.

Don't worry the government will either print money or simply MAKE doctors take less money. Heath care seems to be more important than a doctors freedom to run his business as he/she sees fit.

Self sufficiency taught from birth would greatly lessen the dependence of the population on all forms of support including government and health care "systems".

Terry Teabagger: "If Obama were not raising our taxes though the roof, we could all afford healthcare!"

What planet are you living on ? That is just an dumb statement that has nothing to do with reality - if you join the discussion, please come armed with something a little more intelligent than Glen Beck talking points.

payyourdrbills has it right for the most part. Better yet as the good doctor states, take responsibility for your own health and avoid said bills!

Liberals' answer to any policy question: Throw more taxpayer money at it, effective or not.

If you read the article, "no one read the article", Mrs. Jaquith actually makes the point that the bill increases payments to primary care physicians, but that she doubts it will have any effect on physicians caring for elderly:

"The health insurance reform law will increase reimbursement to primary-care docs by 10 percent. You think that will lead to a stampede of med students to the geriatrics department? Me neither."

The health care reform bill is not the same thing as the "doc fix" which is what the WSJ article is referring. Basically, Medicare cuts are scheduled (due to high spending), but Congress for years kept passing a stopgap measure saying the government will pay for it, increasing the deficit, and the further the stopgap measure to extend the payments goes, the rougher it's going to be when it all comes crashing down.

The doc fix is estimated somewhere around $210 billion (with a B). And due to paygo rules, I can't be certain that it can be easily passed (although entitlement spending may be exempted from the paygo rules).

We are running out of money. Can we afford another $200 billion? How many times can we pass a law saying entitlement spending will get cut a bit in the future, but then basically ignore the law by passing some stopgap measure under the pressure of the medical industry lobbyists/pressure groups when the cuts are set to take effect?

It's a shell game. Three card monty.

Ah yes, I see the right wing big spenders are out in drives this morning, blaming the other 'team' for accepting we have a problem, though they have no answers themselves.

The problems with doctors not treating the elderly or those who aren't covered by expensive health insurance policies is not new. It didn't start with Obama, and the system was just fine with the GOP.

The problem is the lack of supply of health cae practitioners thanks to the AMA, and the blackmail game played by insurers and hospitals so that cahs payers get the short end of the stick.

Maybe if we hadn't spent a ahole bunch of money on a senseless war in Iraq to make the right wingers on this forum happy, we would have been able to train more doctors and nurses and technicians so that the proviers would be available, and the cost would go down.

But NOOOOOO, we need to make sure we keep the Defense Insdustry sucking down dollars.

As a libertarian my biggest disgust with Obama is that he insists on following the big government fascist policies of the GOP. Now we the consumer have even less voice and fewer recoruses against the insurers, who need not do anything about costs.

Sure did make the GOP happy though, didn't it?

All you angry at Obama just blame yourselves.

"if there is a party out there for fiscal sanity, Im all for it, but the tea movement seems to be mostly white fright disguised as fiscal concern. not buying it."

So it is not ok for white people to protest? Why must you use the race card whenever the majority protests? If you haven't noticed the race card has absolutely no meaning to average citizens anymore.

Dave T

Terry Teabagger is a joke poster. Every post he says makes no sense as he is trying to poke fun at what he sees as the ridiculous political movement known as the Tea party. He's neither funny or original

if the teabaggers want respectability,they need to have credible opinions backed by facts. they claim to be fiscally responsible, yet overwhelmingly supported the iraq war; a complete waste of $2T. they claim to be for low taxes, but a recent poll stated 80% of teabaggers had incomes that received tax breaks from obama.

if there is a party out there for fiscal sanity, Im all for it, but the tea movement seems to be mostly white fright disguised as fiscal concern. not buying it.

Each one of us begins getting old at birth. OUR system mandates education based on preparation to find a niche in society to better ourselves and hopefully society itself in the process. Could it be that not enough is taught to maintain our minds and bodies? Self sufficiency would probably at lessen the dependence on OUR $ driven health care system. Granted, elder care for OUR current crop of elders is problematic. Yet; unless all are too old to learn how to better care for themselves, hope is not lost. Information on self care has become ubiquitous in this age of information. Let us seek and use all that we can find to help ourselves...

Long term care is totally useless for many individuals who need care, and are not completely disabled; there are many qualifiers in the policies that disqualify many. I applaud Obama for what he has managed to accomplish in the way of reform, and it is only a start. The future care of the elderly will be provided mainly by nurse practitioners, not doctors.

There will never be enough money to fund all our healthcare demands, which are growing faster than our ability to pay. We spend enough on the health system and the benefits obtained from an additional dollar are marginal. The purpose of our health system is longer and healthier lives for all. The budget is limited and should be focused on getting the greatest improvement in our collective health and lifespan. This is more likely to happen if we do simple treatments well, rather than expecting every new-fangled treatment. After all, who visits a liquor store expecting to buy champaign for the price of beer?

The should be a formal, non-political process to oversee prioritization which should be informed by evidence with input from health care workers and the public. It should not be left to politicians and lobbyists. This will probably lead to a heavy investment in prevention and early intervention particularly for the young and those with lower incomes.

It may also mean fewer hospitals and less end-of-life treatment with greater emphasis on less expensive hospice care. A quarter of all Medicare expenditures occur during the last year of life. These allocation decisions should be de-politicized. Everyone has a responsibility to discuss with their family about what they value in their health and the circumstances they considers it appropriate to withdraw treatment and focus on caring instead. Has anyone considered a "living-will" mandate to receive Medicare benefits?

Healthcare professionals should be upfront about the downsides and risks of medical treatment. No treatment is guaranteed to improve every patient's condition. Tort reform would not be needed if patients' expectations were better aligned with reality. Patients need the option of legal remedies. The question is why are their expectations so unrealistic. Is that as a result of direct to consumer advertising, class action suits, or advertising from the legal system? Patients who receive free samples actually spend more on pharmaceuticals then those who don't receive any free samples (See "Characteristics of patients receiving pharmaceutical samples and association between sample receipt and out-of-pocket prescription costs," by Dr. Alexander, James Zhang, Ph.D., and Anirban Basu, Ph.D., in the April 2008 Medical Care 46(4), pp. 394-402.). Better regulation of the pharmaceutical and medical device industries is called for long before tort reform. The political lobby there is probably too strong to overcome, so your healthcare workers are your best advocate. If your healthcare professional is not upfront about the risks, then you should ask.

Finally, we need to treat obesity as we have dealt with smoking. This may mean being a bit of a nanny state to avoid becoming a nursery state. Ultimately individuals are responsible for their own health.

Money and political affiliation are not the problems. More money to spend is not available. All elected officials depend on more money to fix problems. The problem in the article is the present and future lack of monetary reward for geriatricians, therefore the present and future shortage of qualified geriatric care is a fact caused by OUR medical system whereby big bucks have been the primary motivation for pursuing the MD shingle. While it is irrefutable that OUR system requires long and difficult schooling to obtain MD status, which in itself is $ costly, the fact remains that WE still cannot pay enough to buy the care of those trained to provide said care. There must be a non $ based way to get old.

re:"she doubts it will have any effect on physicians caring for elderly"

That is one person's opinion and should not be mistaken for fact.

The fact is that increased money is required for increased care.

The "doc fix" will require more money or reduced care.

If the issue is increasing care for the elderly, you need more money. If the issue is the fact that we have no money to spend, you have to cut somewhere or raise taxes.

It's not about "liberal" or "conservative" it's about dollars and cents.

My point has been those at the top of this page with their knee-jerk, reflexive bashing of Obama for a problem which is not of his making. It doesn't help.

The untrained (POTUS), leading the uwilling (USus) to do the unnecessary (change).........
Ramalamadingdong has you covered- how's that change working out for you zombies?

There have long been physicians who simply don't take Medicare or Medicaid patients due to low reimbursements. They simply say that their "practice is not focused to provide care to that population of patients". This is therefore, not new. Many people who have foster children (on Medicaid) often say that their regular pediatrician will not care for their foster children for this reason. This can create a double standard in families. Private pediatric care for biological kids, and someone else across town for the foster ones.
However, now we have a new problem. Good physicians, especially specialty physicians about 50, who finally are experienced and expert in their fields, are deciding, in view of looming Obamacare, that owning an ice cream shop, a winery, or a gun shop is a wiser move than hanging in as a physician. If this Obama Regime Health Plan is not repealed, we will see the departure of more strong physicians from the field that simply will never be trained again. This will translate to the unnecessary deaths of many people of all ages.
Why would someone spend four years in pre-med, four years in medical school, a year in internship, three, four years or even five years in residency, and perhaps two years in fellowship, before becoming gainfully employed and even beginning to pay back a choking student debt, unless there were a rational payoff at the end of the rainbow ? The answer is, they would not.

thanks to our best President since i was born

Don't worry, you and i will pay greatly for this health care down the road, i just feel bad for my children when they get older

Slightly over 1/4 of the increased health costs over the past 20 years are due to OBESITY.

Next time you see a fat ass, realize that you are subsidizing his or her poor health.

For those blaming Obama for this pre-existing condition and when the health insurance reform bill has not even taken effect yet, I suggest you read that ACTUAL ARTICLE:

"The health insurance reform law will increase reimbursement to primary-care docs by 10 percent."

Sooooo.... it sounds like the health insurance reform law is ACTUALLY DOING SOMETHING to remedy this situation. Not passing the law would keep the status quo, to which this blurb and the linked article refer.

It's really unbelievable. There is an article decrying the state of our healthcare system. People get on the message board to bash Obama for passing a law which HELPS REMEDY THE SITUATION.

These people that opposed health insurance reform clearly are ill informed or not very intelligent. The comments on this page prove it.

@no one read the article?

You forgot to add that those who oppose our socialist, "spread the wealth" prez are racists.

You also might want to check on how government health care in other countries ALWAYS leads to health care rationing. But don't you worry about the health of the likes of Obama, Pelosi and Reid. They'll be able to jet off to Zurich, Costa Rica or wherever to get their health care needs taken care of when they get old. No need for them to wait in long lines with the rest of us.

"government health care in other countries ALWAYS leads to health care rationing."

So what's the solution? You seem to NOT want to change anything. But the article that you're posting a comment on points out that the SYSTEM AS IT IS results in senior citizens not getting health care.

Sooooo... you are in support of senior citizens not getting health care and are mad at Obama because he's trying to fix the situation and you're mad at him because it's going to cost money?

Gee.... I wonder how this country racked up 10 trillion dollars in debt before Obama took office with the geniuses like anotherobamastinks voting for our elected leaders!

Private insurance is clearly not the best way to cover medical needs. But any government run system for anything bears extreme caution and deliberation before any consideration for implementation. The health care situation is not easily resolvable if one is attempting to solve everyone's problems. The medical community in its effort to better the human condition has managed to prolong lifespans. Now it wants to abandon those patients it created? Is this a viable solution? Maybe health care should be abandoned. If people only lived until they died instead of being kept alive by those trying to profit from their kindness, at least elder care might be achievable.

and I would NEVER suggest that you're racist for opposing health insurance reform.

I have clearly and succintly stated that you are, instead, unintelligent or misinformed or dishonest or a combination of all three.

You claim to be opposed to cutting senior citizens healthcare. You blast Obama for trying to fix the problem. You preemptively attempt to say that I"m calling you racist when nothing could be further from the truth.

Instead I am calling you d&mb and a liar.

Prove me wrong.

I suggest all of you who plan on living past 75 get long term care insurance. or else your life savings and your kids' will be wiped out paying for your nursing home.

$80K a year and up.

Although I'm not a tea party member, I think it is foolish and arrogant to so harshly criticize a group of citizens whose common trait is concern over the financial, moral, and political deterioration of our country. They're still trying to figure out how best to express that concern as a group, and constantly slinging mud at them only serves to strengthen their resolve. The GOP and DEM parties aren't the ones growing. Practically every discussion on every topic in this forum at some point includes some denegrading remark about "teabaggers." Feeling threatened?

"a recent poll stated 80% of teabaggers had incomes that received tax breaks from obama."

They were also more educated than the average citizen, and much less likely to be on unemployment,welfare, or receive state aid. Might as well leave the part out that might explain their aversion to increased taxes.

JJ stated

"They were also more educated than the average citizen, and much less likely to be on unemployment,welfare, or receive state aid. Might as well leave the part out that might explain their aversion to increased taxes." about teabaggers

Not sure that being more educated than the average citizen should be one of your bragging points - I've not heard much from the movement that passes a fact check. If the members of teaparty want to be taken seriously they should do a little homework before they talk. They may have legitimate concerns about government, but destroy any credibility they may have by many of their outlandish statements.

Sorry folks; I just do not understand what all the political banter is about. The commentary started on the loss or potential shortage of heath care for senior citizens. I guess my comprehension level of the English language is just too low to see the relationship between politics presented here and living to be old. Can anyone explain?

"They were also more educated than the average citizen, and much less likely to be on unemployment,welfare, or receive state aid. Might as well leave the part out that might explain their aversion to increased taxes."

Nope. All that says is that Tea Baggers have no trouble with big government and big deficit as long as it's spent on something they personally approve of. The DOD is the biggest ticket in the budget. Why Tea Baggers don't think they should have to pay their bills is beyond me.

When you lok at the demographics of those baggers another interesting picture emerges. Turns out they are predmoninantly white males with college degrees over the gae of 55. Hmmm. You mean the demographic that has never faced more than 6.5% unemployment during downturns? Now suddenly they are finding out that their jobs aren't secure either, even if they aren't white males. They are finding that they can get fired too, and be forced to lower paying jobs through no fault of their own.

Could it be they are angry to find that it wasn't that women and minorities were lazy, they were being kept in lower economic standing through no fault of their own.


Yeah, I'd be angry too if saw my cushy place in society slipping away. But they voted for it, so they deserve it.

cvldrnk, Sometimes these blogs get a little messy

ken jamme, thx for the reality check. What an understatement! The original issue of the blog is still open for suggestions.

The mere fact that there is a third party movement should thrill and excite most americans who are concerned about the current party of "Republicrats"

Anyone in health care understands our system is broken and needs reform, even the majority of doctors understand this. The reimbursements, thru medicare, to surgeons and other specialties needed to be cut, but cutting the primary care docs is a mistake. Their payments should be increased and the country should get rid of the enormous cost of private insurance and go to a single payer government run system. Those fighting this change are primarily older individuals that benefit already from government health care-medicare. If they are unable to continue their health care benefits, paid for by the government, or doctors refuse to see them -watch out .

It is quite shocking to me that our former part-time law school lecturer/Senate back bencher voting present/community organizer/friend of bomber Ayers/no executive experience whatsoever Teleprompter In Chief Prez is somehow turning out to be the most miserable failure since Carter. Who would have thought it? Maybe I should just believe in what Katie Couric, Brian Williams and Diane Sawyer tell me instead of relying on my lying eyes. You all better hope and pray that we can vote enough Senators and Representatives
into office who are non-Obama Kool Aid drinkers to repeal and undo all the damage Hussein has done to our country. Starting with ridding us of Tommy Boy in November.

Has anyone ever actually looked at what your doctor charges you for? They be gamin the system, yo. Treatment facilities be inflatin charges - constantly coding things higher than necessary and basically goin for a cash grab. Makes Tim Brown sick. Everyone complainin bout da health insurance companies when da doctors, hospitals, and others just be billin out they damn minds - whether it be to pay for new equipment or just to get that money... money... YEA-YEAH

and furthermore.....

where is the money supposed to come from? I ask ONE of the people bashing Obama for the 1.2 trillion dollar deficit (which he inherited from Bush) the 10 Trillion dollar debt (which he inherited from Bush) the wars in Iraq and Afghanistan (which he inherited from Bush) the millions of unemployed (which he inherited from Bush) to tell me EXACTLY HOW we are to pay for increased medicare spending.

These people blame the reform bill for the situation as it is (not very smart, clearly) and the solution is INCREASED SPENDING, which they oppose (displaying cognitive dissonance to a high degree).

They are thoughtless and are providing no constructive dialog.

Show me the money.

How, EXACTLY, are we to pay for our aging population without increasing taxes or reducing our defense budget? Please don't ignore the word "exactly". If you say, 'cut gov't waste' but ignore the defense budget, SHOW ME THE MONEY.

I am calling out all the tea-baggers. Their comments on this page show them to be dishonest and unintelligent. I challenge them to prove me wrong.

Show me how to do it, anotherobamastinks. Stop repeating specious and facile talking points.


First off, I'm no great supporter of George Bush, although he was MUCH better than Hussein on national security, anti-terrorism (now you can't even call them terrorists), etc. I even had to hold my nose to vote for McCain. That being said, there are ways to help fix the current health care system short of moving to national health care, which has already proven to be disastrous in other countries (did it seem strange to you that the Premier of Newfoundland went to Florida for heart surgery? []). Health insurance across state lines for more competition/lowering of costs. Limits on medical malpractice awards for clients of ambulance chasers. Do SOMETHING about illegal aliens who get free medical care and cost the medical system 21 BILLION dollars last year.

Oh yeah, one last thing. Stop buying the crapola Hussein continually puts out blaming George Bush for anything and everything that goes wrong. He should man up and TAKE RESPONSIBILITY!!!! This tactic of his might work for the Kool Aid drinker libs, but rational people aren't buying it.

I'm not blaming Bush for what GOES wrong. I'm blaming him for what WAS wrong when Obama took office.

You can't change facts. Bush inherited a huge surplus and a chugging economy. He had a HUGE opportunity to show the country how a conservative government could work. He could have fixed social security and medicare.

Instead, all he wanted to do was cut taxes and coast to re-election. 9/11 changed his plan and he then proceeded to send the government's balance sheet into the crapper because he refused to pay for his defense and discretionary spending.

Say what you want about Obama's policies, but don't blame him for the situation he is trying to fix. It makes you look (as I said) unintelligent and dishonest.

RE:"Health insurance across state lines for more competition/lowering of costs. Limits on medical malpractice awards for clients of ambulance chasers. Do SOMETHING about illegal aliens who get free medical care and cost the medical system 21 BILLION dollars last year. "

Some actual substance here. The connection between these policy proposals and senior citizens receiving better and more care seems tenuous, however.

If Obama were not raising our taxes though the roof, we could all afford healthcare!

JJ, how will we pay for the long term care insurance? Paying more $ to a system that gives no support and has an unquenchable thirst for $ is not the way to go.

Oh c'mon. Instead of borrowing a trillion dollars to spend on buying GM to help the unions and to send to state governments to keep hiring public employee and give them raises - there was plenty of money. It was just wasted on the wrong things.

Bush's deficit was awful but Obama's is a couple of times worse.

Politics aside, does anyone out have a suggestion to help the elders?

fdr: it's simple--can't we just print more money to pay the doctors?

I said all the payment's come from people's pockets regarding health care, but it is true that with borrowing we are not making those pocket's be our future earnings and our children's earnings. Hope they have a hot economy because they will desperately need it to pay off our bills.

so many of these responses are completely incorrect. personally, i dont care about doctors and their income. nothing worse than a doctor complaining about money. so doctors are dropping patients as they can no longer find ways to rip off medicare (or the US taxpayer)? thats a good thing. many doctors like medicare as they get a clean check and are not subject to the bullshat and manipulation of their money by private insurance.

every country that the US considers to be a economic rival offer some form of healthcare that does not burden private industry. if you crazy free marketers would stop and think for a moment, you would realize that a new streamlined HC system in the US is actually critical to remaining competitive.

Chouva, all forms or providing health care burden private industry in the end since that is where production happens. Business's can pay for it, patients can pay for it, governments can pay for it - but in the end the payment's come from people's pockets.

The political winds may change, as baby boomers struggle with the lack of health care for their parents, and understand what lies ahead for themselves.

Your website has been extremely informative.Thanks for the post