CNN Money has an article today (probably "yesterday" by the time you read this) about Doctors increasingly seeking the dubious protection of Chapter 11 Bankruptcy. Most of the piece is largely fluff- all emotion and "analysis" without ever really touching on the subject. I will leave the speculation of why that's so to others, but I think I have some hints.
Here's the first one:
Five years ago, Plantation, Fla.-based bankruptcy attorney David Langley didn't have a single doctor as a client. Since then he's handled at least six bankruptcy cases involving doctors. Two current clients -- an orthopedic surgeon and an OB/GYN -- also are in bankruptcy.
Hmmm... What could possibly have happened between 5 years ago and today? I got nothin'.
Now, don't pay attention to this, as it's a Red Herring:
The weak economy has taken a toll on doctors' revenue, as consumers cut back on office visits and lucrative elective procedures, said Guy, a bankruptcy attorney in Nashville with Frost Brown Todd LLC.
Why do I say it's a Red Herring? Because all of the actual doctors cited in the article are doctors not known for their "lucrative elective procedures." Mentioned are: an orthopedic sugeon, an OB/GYN, an Oncologist, and "Primary doctors." Not listed? Cosmetic/Bariatric sugeons. If "cut[ting] back on... lucrative elective procedures" had anything to do with it, don't you think people who specialize in "lucrative elective procedures" would be at the forefront of bankruptcy filings?
So, back to finding hints about why CNN Money might have written a piece which was largely "human interest" and very light on actual facts.
Hint number 2 is here:
Doctors also blame shrinking insurance reimbursements, changing regulations, and the rising costs of malpractice insurance, drugs and other business necessities for making it harder to keep their practices afloat.
I should note that in the linked article, those words "insurance reimbursements" (meant to make you think BlueCross, Aetna, and United are paying your doctor less) are a hyperlink to an article titled: "Medicare doctors' pay to be cut." That article blames the (by then already) largely averted Sequester. In reality, you can blame lower Medicare reimbursements on ObamaCare.
Wait, I said I wasn't going to speculate. Whoops.
No kidding about the red herring, an oncologist has pretty much the *opposite* of a "lucrative elective" type practice. The use of "insurance reimbursements" when the truth was the reduction of Medicare payments is pretty much media malpractice.
ReplyDeleteYou forgot to mention that decreases in Medicare payments were already planned in 2011. In fact, a 27.4% Medicare physician pay cut was planned to take affect 01Jan2012. http://www.amednews.com/article/20111114/government/311149949/1/
ReplyDeleteCompared to the planned 27.4% decrease, a 2% cut is minimal.
Your "hint #2" includes "rising costs of malpractice insurance"; OB-Gyn physicians have among the highest of malpractice insurances. An earlier CNN Money article has an anecdote from an OB-Gyn who paid 125,000% in yearly malpractice insurance.
Reimbursement by Medicare has historically affected the reimbursement rates of private insurance companies and led to medical innovation, Hospital and HMO cost-cutting efforts, and the adoption and abandonment of procedures/medications by physicians. For example, cataract removal was once a very lucrative procedure for Medicare reimbursement, and many physicians made fortunes in Florida before Medicare slashed the reimbursement. Private insurance companies use the Medicare reimbursement rates as a baseline when paying hospitals for procedures, so it is logical that when Medicare rates decrease private insurance organizations renegotiate rates as well. Cosmetic/Bariatric surgeons can have lucrative practices due to increased obesity in the U.S. population, less invasive procedures such as the adjustable Lap-Band device placement, and reimbursement from Medicare due to the understanding that bariatric procedures reduce mortality from diseases such as Hypertension, diabetes, and cardiovascular disease.
To suggest that a 2% decrease in Medicare reimbursement is the largest reason for physicians leaving medical practice, or a direct effect of the affordable healthcare act is intellectually dishonest and ignores many of the larger reasons for physician bankruptcy.