Doctors and Medicare Patients

September 17th, 2003

To the Editor,

In a letter to the editor on 9/17/03, a Dr. Levitt opined that doctors who treat medicare patients should not accept assignment but require all fees up front. This requirement would then “…reduce the number of …unnecessary visits, …as well as perhaps improving the doctor’s cash flow,,,”. Perhaps Dr. Levitt only likes to treat patients with a healthy bank balance. I wonder if he is honest with his non-medicare patients who pay up front and tells them when their visits to him are not necessary?

Failure to accept assignment is what leaves many patients on medicare to sacrifice good nutrition and decent housing in order to afford specialists and medications. Patients truly using a doctor’s office for socializing can be advised to attend senior centers unless meeting cash flow needs alters the physician’s determination of what constitutes a medically necessary visit…

Disabled persons also receive medicare and the SSA tells us three out of ten workers become disabled during their pre-retirement years. That is a huge number of younger persons who are ill and have not been able to save for a traditional “retirement”. Most went broke in the months/years of illness prior to qualifying for disability benefits. One must also be disabled for two years before medicare eligibility “kicks in” and must do without insurance altogether given the high costs of COBRA policies.

Advance payments are impossible for this segment of medicare recipients. People on disability are also required to see doctors frequently in order to document their continued status, whether or not actual treatments are being offered. Doctors should work on the government to improve timeliness of payments instead of reducing patient access to services.

And, if services are superfluous for a particular patient, don’t give them an appointment.

Barbara Rubin

Categories: NY Times

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