Quote:
Originally Posted by BrianL99
With all this talk about Medical Billing and Medicare over-billing, the people who are paying attention to what's being posted, should be getting an education on how ridiculous the US Medical System has become.
A Primary Care Physician, fresh from certification and Residency, gets paid somewhere around $250,000 per year. One with 10 or so years of experience, is likely around $300,000/year.
With the burden at 40% (medical insurance, FICA, unemployment insurance, benefits, etc.) the cost of a medical provider to employ a primary care physician, is between $350,000-$400,000/year. That works out to a cost of $187/hour (2000 working hours per year).
Medicare (for example) pays about $187 for a 1 hour office visit. Assuming a Doctor spends 40 hours per week with patients (no non-productive time doing paperwork, researching, thinking or having lunch), the money from Medicare just covers the Doctor's salary. Where is the provider coming up with the money to cover admin staff, overhead and profit?
Which might lead someone to conclude, the only way medical providers stay in business, is for Primary Care Physicians to "sell" other services. Lab work, tests, procedures, etc.?
I guess it's no big secret why providers are pushing PA's & NP's as doctor replacements.
What am I missing?
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Of course, out of that $250,000, those young doctors have to pay large amounts of tax and they have to repay their med school loans. In private practice, they also have to pay for rent, employees, and all that. Around here, young GPs often went to low-rated med schools. They passed their exams, but you don’t know whether they were nic in their class standing or at the bottom. Doctors who were at the top of their class are likely to be much better at diagnosis. The life saver—literally—is that these days, lots of these mediocre doctors and physicians assistants and nurse practitioners (who may be good, but their training was only med school LITE) have excellent programs on their laptops that coach them in what to notice and ask about. They soon improve a lot. Still yes, their job is mostly to diagnose and dispense for minor problems and know when to refer patients to specialists. Sometimes they can get the patient in to see a specialist quite quickly.
I’ll mention something I mentioned last week. The best thing about Medicare and my supplemental insurance (Blue Cross/Blue Shield from Pennsylvania) is that hospitals and doctors can bill whatever they want, but the insurance decides what they will pay and what can be passed on to the patient. Thus, I had major surgery this year using the Da Vinci Robot, a top specialist, radiologists, MRIs and CTs, etc. The hospital and doctors billed me about $130,000. My two insurances paid about $15,000 total between them. I paid only my $257 annual deductible. This is why hospitals and doctors are using creative billing. If they claim you make minor heart arrhythmias, that might get them an extra $100 after they bill $1,000 for it. The Villages Imaging may bill $5,000 for an MRI or CT scan using machines that cost a million or more but get paid $150 to $300. Really. Being a doctor is not necessarily lucrative these days, especially if all your patients are on Medicare or Medicaid.