ATLANTA --- Dr. Howard McMahan has reached a decision. If the governor's budget becomes law, he'll stop seeing new patients who are poor enough to qualify for Medicaid.
The 55-year-old family physician is one of three doctors in tiny Ocilla who accepts Medicaid patients, and if he stops seeing new ones, they'll probably add to the crowds in the hospital emergency room, he predicted.
His reaction is similar to dozens of others forecast by medical groups opposed to Medicaid-rate cuts in the budget being considered by the House this week.
Dr. McMahan skipped the lucrative specialties such as surgery and big cities to care for patients in a small town where the need is great. Now that Medicaid payments to doctors are set to be cut in next year's state budget, he feels cheated.
"We doctors really feel we have been betrayed by our government," he said. "The thanks that I get for it is the continued demand from our insurance companies, from our government, and by proxy from the general public. ... I've personally just had enough of it."
The House is likely to consider the budget this week or next. It includes large cuts in every area of spending, but the medical community complains its cuts could have noticeable consequences, such as layoffs, the closing of free clinics, and increased insurance premiums for the public.
Doctors know their profession's image of big incomes and egos doesn't make them very sympathetic figures. But many primary-care physicians who see mostly Medicaid patients estimate their incomes are no higher than someone owning a small business.
Dr. Wayne Hodges, a family practitioner in Savannah, Ga., has already begun turning away his Medicaid patients because the fees the state pays are below his costs.
"We were essentially seeing Medicaid patients free anyway. So with the ... cut, ain't no way," he said. "It's not from a medical perspective of being offended. That's not it. ... We cannot exist."
When next year's budget was originally proposed, Medicaid physicians were to get a 2 percent raise -- their first in seven years. But slumping tax collections prompted Gov. Sonny Perdue to reverse course and instead cut 6 percent to 10 percent.
He is using $500 million received from the federal stimulus package for Medicaid, which frees up the same amount of state money to stave off deeper cuts in education, public safety and other government services, according to spokesman Bert Brantley.
"For them to want to just keep their rates at the current level when everyone else is taking a cut is tough to justify," he said.
Many medical groups say Mr. Perdue should boost Medicaid spending by supporting a $1-per-pack increase in the cigarette tax, proposed by Rep. Ron Stephens, R-Savannah. Mr. Brantley said the governor recognized that Mr. Stephens' bill would not pass. It didn't, dying Thursday when it failed to get past the House Ways and Means Committee.
Mr. Perdue originally proposed funding the higher Medicaid rates with a 1.6 percent tax on the revenues of hospitals and health-insurance plans. The tax also would have produced enough money to partially fund a network of trauma-care hospitals. Mr. Brantley said the tax was a modest amount, spread broadly to minimize its pain.
Hospitals opposed it. Few would have received more money than they paid, with the bulk going to large public hospitals such as Atlanta's Grady and Savannah's Memorial, according to Paul P. Hinchey, the president and CEO of St. Joseph's/Candler Hospital in Savannah. The opposition was based on those cost projections, he said.
"We wouldn't have reacted to this just emotionally," he said. "That wouldn't have been fair to the governor. That wouldn't have been fair to the Legislature."
Lawmakers have heard those dire projections, predictions and personal stories from doctors and hospitals across the state. If they decide to reject Mr. Perdue's recommended Medicaid budget, they'll either have to make large cuts elsewhere or raise taxes -- a notion most reject as too dangerous during a recession.
Reach Walter C. Jones at (404) 589-8424 or walter.jones@morris.com.
Comments
Typical money grabbing pill pushers.What's wrong:writing out those prescriptions after a 10-15 minute consultation getting to be a burden for Medicaid folks? I guess those freebie pharmacutical "conventions" at exclusive resorts are out as well: right?
iletu--Why should they LOSE money seeing patients? Your unknowledgeable views are exactly the mentatlity discussed in the article. Not every doctor is rolling in money. Give the small town guys a break!
whats the matter ilet....got a little "Dr" envy going on there? Why in the hell should Doctors be forced to treat patients for free....??? Do you work ??? Andif you do...do you work for free????
Gotta agree with NEone. Just like the first doc said in the article, it's really like they are people with a small business, so the small town guys are NOT making the big bucks like the guys in specialty practices are. They went to school and studied for a long, long time, so I don't begrudge them making an above average living. Medicaid and Perdue are just sniffing out the money, and then cutting it wherever they find it, whether it's fair or not.
I love socialism ,don't you
What idiots we have running this country
Thanks to all of you who voted for the dems.
Help me understand the Governor's decision: He cuts Medicaid reimbursements to doctors to save money, more sick folks use emergency room docs as their primary care physician, Er rates are significantly higher than private practice rates so medicaid reimbursement claims skyrocket. I'm not sure I see the logic in his decision. The problem is that the Governor and many others in Atlanta want to continue to do things the same way and expect different results, I believe that is the definition of insanity.
Doctors are easy targets for law suits and must buy exorbitant liability insurance policies to protect themselves and now, the income from the socialist programs continues to shrink. Doctors still have the ability to not accept Medicaid patients. (Soon, this ability will disappear.) Get used to doctors in general cutting back services as insurance companies and governments and other guarantee entities cut back on these guarantees. This is what socialized medicine offers and we're just at the beginning. Wait 2 more years and see if you're even happier.
Many hospitals have closed their emergency rooms. Is this the next step before all medical services become socialized? Stand by for more socialist improvements.
I work as a buyer of medical supplies for a hospital and I can assure you that medicaid reimbursement most times does not even cover the cost of what the hospital pays for supplies especially in the ER. ERs will cannot afford to stay open. These are not money hungry entities but it would be nice to at least get your money back instead of working at a loss.
You people don't fret... your savior in the white house will come to your rescue. Just look at the mess he has made so far and just have faith he will improve... Yeah right, when pigs fly.
If this budget passes you will see many of our small rural hospitals close or cut back on services. Sonny Perdue has been against health care his entire tenure as gov. He is mentally unstable, bullheaded and not very bright. He is refusing millions of federal dollars with this proposed budget. For every dollar spent on medicaid, the state receives two additional dollars from the feds. For every dollar spent on a medicaid patient, hospitals and heathcare providers receive only eighty-four cents in return.
wcr250: I thought Perdue was a republican!!! This is about the governer;s budget, how did our savior in the white house get in this conversation?
ColCo: hospitals received a fixed reimbursement for seeing medicaid pts. if this passes, the reimbursement will be less for hospitals already under paid. then doors will start closing.
Its simple to correct. Just remove doctors from providers listings when they refuse to care for new patients. This should be no problem for most like the letter writer, because they are loosing money anyway. I am sure this doctor is only looking out for his patients and greed never entered into his mind. BTW if you do business with a small business and they mess up the work, you don't pay. But if you go to a doctor and they mess up you are still expected to pay. BTW Patricia, why is it docs always talk about percent of increase for insurance and never hard casj amounts. Well the reason is if you are paying one dollar and it increases to two dollars that is a 100% increase. Another thing they never talk about is what their liability is as a part of their total yearly income. Well if you are paying $250,000 for insurance but your income is say $1,000,000, I would kinda doubt you are really hurting financially, and your high cost may be because you had too many lawsuits for botched procedures,
WCR that wasn't a Dem making the decision unless Sonny has jumped ship. And Squachief, if they close then I would bet a new one is standing ready to take their place at reduced cost. Supply and Demand. BTW I still am smarting for the thousands they charged me for two nights (a total of 7 hours each night) in MCG and I didn't see a single physician, and that clinic pulls hundreds of thousands a year from medicaid.
Doctors in independent practices are not LIKE small bausiness, they ARE SMALL BUSINESSES. Like it or not, if the cash flow in is less than the cash flow out, the medical practice, or business, can't last. The fee paid to the doctor pays not only the doc, but al the other expenses going along with the practice like utilities, building rent, insurance, pay and benefits for staff, supplies, etc. Like any other small business the owner gets whatever is left over as profit, if there is any. Building owners, banks and mortgage holders don't generally cut any slack for medical practices.
OK now correct me if I am wrong, we have 4 non-profit hospitals, this means that the hospitals are to run on a budget and not make any more than what is needed to run the facilities, clinics and external units. But, if the administrators are able to come in under budget by cutting overtime and limiting what the "little" people make they now get a big fat bonuses to show how well they did. If the average bonus is 25% of the administrator's yearly income and the mean for an administrator is $125,000 before bonuses, shouldn't administration have to forgo the bonuses in favor of putting funds back into the hospital and not their pockets. --------A friend of mine has always said there is no such thing as a non profit organization, someone in the organization is making a profit.
disssman, if your income is $20, 000,000 a year and you pay $1,000,000 in liability insurance, you just fine. How does this apply? More assumption precipitated by wealth envy? When your genius point of view, which many lefties share, drives doctors from any social programs, you'll use the power of the government to take from them anyway. What a good and farseeing plan. By the way, MCG pulls millions per year from medicaid and loses millions in the process, which we, the taxpayer, still makes up with different programs.
A non-profit organization doesn't mean everyone works for free using free materials in a free building with free utilities. Government schools are no friend to this country.
Gee. I remember someone last summer mentioning the Dr's reactions to the influence of bureaucrats driving down rates. I told you so.
squachief says, "Sonny Perdue has been against health care his entire tenure as gov." What an idiotic statement! The focus should be what to do about the revenue shortfall. Unlike Feds, GA can't just print money for all their spending. There has to be cuts across the board. Everybody complains about wasteful spending except their pet issues. In this case, medical reimbursement.
PT Just cut and paste one comment that mentions "socialism" Redistributing the wealth", wealth envy" and "government schools" That way it will save you time and we won't waste our time reading the same drivel over and over.
If the doctor has an office he has to pay his staff, his taxes, operating expenses, etc. from what he gets from his patients whether it cash, insurance or medicare. So, if there's less money from the get-go it filters down to everyone.
TechLover, just cut and paste ssdd so you can continue to promote socialism without thinking...which is the only way to support it. Personal responsibility should never cross your thoughts.
This is just a small example of what you will see once we get National Healthcare. The government will try to control costs by continually cutting what it will pay and the doctors will either go out of business or will only see people who can pay or who have private insurance. National Healthcare is no good if there are no doctors that will see you (which is what happens everywhere else it is tried).
We have a Republican Governor and a Republican Legislature. If the state govt is short on funds, why don't they just pass a few more tax cuts?? After all, to hear the Conservobots tell it, that IS the solution to every problem...
Lets put this in terms some may understand better. Lets say the state decides that they will buy gas for the poor, and set the price they pay to $1.50/gal. What do you think will happen to gas stations that had previously sold 75% of their gas primarily to these same poor people? They can choose not to accept the states payment, effectively driving off 75% of their customers which will eventually drive them out of business. Or they can accept the states price, loosing money on every gallon they sell. So if they want to stay in business who's going to foot the bill? That's right. The same hard working people making good money and paying the taxes that have already paid for the poor folks $1.50 gas will now also have to pay more for their own gas. Healthcare is no different. Doctors are frustrated because they are getting squeezed from both the government and the insurance companies and nobody cares because you all think they all make millions of dollars. A two tiered medical system is coming, with the best physicians and hospitals catering to those who can pay, and another system for those on government aid.
After reading all the posts so far, the ones that made me laugh the most (can always count on them for comic relief) is dissman, momofthree and justus4. Wow, talk about the clueless in motion. I also can imagine these three are a prime example of people who look at medical costs as the last thing they will make sure to pay when they get their bill. You see that is also factored in to the equation of whether or not Doctors or Specialists will continue to provide services in the future. What the ignorant 3 do not mention (maybe because they are not informed) is that both medicaid and insurance fee schedules have been cut drastically.
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