This morning my wife shared a letter just received from her former health care provider in Santa Fe, New Mexico. She writes that she’ll no longer bill insurance, with the exception of Medicare. To continue with her, she asks that you join her health community at $4100 annually. Medicare recipients must also join.
I ran into this same thing two years ago when I saw a specialist for a leg ailment. In the future, her clients would need to pay a $3700 annual retainer fee. That was two years ago. I’m reasonably sure with inflation her fee has increased.
I want to warn you that American medicine, formerly the finest in the world, is likely to become more expensive, limited and inequitable. Increasingly with the rise of corporate medicine, the emphasis is on quantity rather than quality. On average, you may need to wait several months before accessing your primary care physician, and even more to see a specialist, and when you do, it’s a physician’s assistant.
Concurrently, private insurance coverage is becoming more discriminating in what it pays for and how much. Medicare payout to physicians suffered a 4% cut this year, with an additional 4.5 anticipated cut for next year unless Congress intervenes before its adjournment next month.
Cuts like these result in reduced treatment, hiring of staff, and implementation of new technologies.
In response, doctors are increasingly resorting to concierge medicine, i.e., retainer fee medicine, now averaging $4000 annually per individual. Obviously, this will accelerate the already large number of Americans foregoing or delaying medical treatment, resulting in tardy diagnosis of mortality threatening illnesses.
As for hospitals, Mayo Clinic, accepts Medicare, but will bill you for the difference between original billing and Medicare payout. I fear this may become a growing trend.
—rj
Brimmings: up from the well 