tag:blogger.com,1999:blog-2308282620289958037.post8522863842662707384..comments2023-08-08T08:41:19.586-04:00Comments on The Medical Contrarian: Health care gluttony and grazing at the all your can eat health care buffetThe Medical Contrarianhttp://www.blogger.com/profile/09240492315542223258noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-2308282620289958037.post-1993098256294650812010-04-02T07:50:17.007-04:002010-04-02T07:50:17.007-04:00A common experience in my practice is the Medicare...A common experience in my practice is the Medicare patient who comes in with a benign skin lesion, her family physician has correctly assessed as such but "She just thought she'd have me check it out." Medicare, meaning the payroll tax paying population, just paid for that visit, essentially paying for the same evaluation twice, as well as paying for the government employees and carrier contractors who administer the system. I netted on this level two visit about $10 and her presence there displaced someone else potentially with a more serious problem. It is doubtful if that person had to pay even the Medicare fee of $66, much less the fee-for-service fee of $145 she would have sought a second opinion or she would have asked her PCP for reassurance that he was confident of his diagnosis. And if I did have to accept Medicare's marginally profitable reimbursement, I would not have to cost shift to private patients and my fee for any initial office visit to allay this woman's anxiety would be less than $145. QED. As to the WSJ editorial citing "excessive Medicare reimbursement" as a problem—that is an oxymoron. CAMChauncey McHargue M.D.noreply@blogger.com