MY SAY: SENIORS BEWARE
Handshakes all around when Obamacare is replaced, but for seniors on Medicare nothing has changed for the better. During the Reagan administration a major change occurred for those on Medicare. Previously, seniors could purchase additional “major medical” insurance which would pay those expenses not covered by Medicare which set the reimbursement fees for doctors of all specialties.
However, under Ronald Reagan, the schedules for reimbursement to the physicians was set as the bar for all “medigap” an “major medical” plans.
To simplify: Let us say a doctor charges $850.00 for a procedure including the services of an anesthesiologist. An actuary in Washington working for the government decides that $475.00 is the “acceptable” fee and the doctor is paid 80% of the acceptable fee which comes to $380.00. The “medigap” insurance is tied to that number and only will add the 20 percent deducted by Medicare which is $95.00. The doctor is then forced to accept the fee that Medicare has set and cannot negotiate with the patients or he will lose participation in Medicare.
For this reason, throughout the country, doctors are not accepting Medicare insurance.
This is a form of price controls that the government uses, and even if a senior accepts the facts and fee for service, Medicare insurance is still deducted from the monthly social security checks.
With the new healthcare bill will this still remain? Stay tuned. rsk
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