Healthcare Reform-One Person’s Opinion

by Michele Carter-Graham on April 10, 2010

Healthcare in the United States is on everyone’s mind. Whether you have good coverage with your employer or individual coverage or government insurance, you are probably like the rest of us regarding the new reform recently passed: what does it all mean?

When Medicare was originated, there were issues and controversy as well. All insurance companies now base their fees on a percentage of Medicare allowable. What that means to the consumer is that medical providers are paid less according to what Medicare deems reasonable and customary. From there, private insurance determines what they will pay a medical provider based on what Medicare will allow. It hardly seems fair to the healthcare professionals that have spent so much time in school to get a medical degree so that the rest of us can be treated and kept well.

With the new healthcare reform, it is questionalble how are the medical providers going to make enough to stay in business? Medicare has already begun to reduce fees to doctors. Many of the doctors I have spoken with will continue to treat the Medicare patients they have but have expressed they will not be taking new Medicare patients. therefore, the many baby boomers that will be eligible for Medicare in the next couple of years may have a problem locating a doctor to treat them.

Additionally, many of the private insurance companies are now reducung their payments or fee schedules to medical providers as well. Doctors are now beginning to rethink if they want to participate with certain insurance companies for this very reason. Doctors and other healthcare professionals are in business to make a living. Their rent, utility and supplies are going up and payment is going down, so how does the government expect our existing healthcare providers to survive? Does the new heathcare reform address this issue? I don’t think it does.

I remember many years ago, some people didn’t even go to the doctor unless it was an emergency, due to the expense. Even with private insurance, the policies are written so that if a person does become ill, it could bankrupt them paying copays and coinsurance. In the past (many years ago) if you had the flu a doctor would send in a script and not make you come in to the office, whereas in this day and age, this is not true due to the fact that they need your copay and coinsurance to try and survive themselves.

Even with healthcare reform, how is the person that can’t afford insurance or afford to see a doctor, going to come up with the imposed penalty for not having insurance? All remains to be seen but in my opinion and this is only my opinion, we still have a long way to go for this reform to help everyone.

About Michele:
Michele Graham is the CEO of Professional Healthcare Management, a leading provider of medical business management services. Professional Healthcare Management started in 2003 and offers services to all medical professionals for credentialing and insurance contracting. We have performed services for over 3000 providers and multiple hospitals, surgical centers and wound care centers. Our fees are competitive and our staff is comprised of experienced professionals with years of experience in the healthcare industry. Michele has over 40 years experience in healthcare and we welcome anyone having issues getting contracted or getting paid. We try and negotiate better reimbursements for each and every for more information!

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