Fixing Medicare Part B - WHAT WOULD YOU DO?

@BalbonisMoleskine 

I think you are probably talking about specialist - certainly not for primary care physicians like family docs, internist, primary care or general practice.  

And I don’t think we can tell docs how many patients with a specific insurance type they have to take - we can’t even tell them to accept Medicaid.  

Not as a condition of licensure or any other DEMAND.  

Under Medicare FFS, CMS sets the reimbursement rates for specific covered services and bundles those that are paid together.  There is already about a 3% proposed cut in physician pay for next year - it came from last year.  Especially at a time when we desperately need MORE primary care.

Got any other solutions for our premium problem with Part B?  

One of mine would be that we do away with self-referral to a specialist in Traditional Medicare.  Let the primary care doctors do the referrals if needed.  This is the way it is in most other countries with a single payer system.  Some thing just don’t need a specialist care or a higher price tag just because they are a specialist .  Primary care docs can handle a lot of different things.  

@WebWiseWoman 

Now that is funny what you thought about the ACA.  But you are wrong about medical inflation - this is like any other type of inflation.  Medical inflation also happens because of usage.  If we all had auto insurance but there was never a claim, then the cost nor the premiums would rise for auto insurance coverage.

Cost rise for all businesses - a lot of it has to do with government regulations.  People want higher pay for the work they do - be them a doctor, a nurse, a pharmacist, a PA or NP - when that rises, so does the cost of their employment - workman’s comp insurance, unemployment insurance, professional insurance.

Then there is the cost and development of drugs and medical devices - very expensive.  

The best way to keep down the cost of medical insurance of whatever type is not to use it or only use it when absolutely necessary with perhaps some splurging of preventive care.

Private insurance companies have ways to hold down their cost and premiums - they can set prior approval standards to prove medical necessity, they can establish step therapy - where you try the least costliest treatment or med to see if they work before advancing to the more costly.  Quantity limits are used in medication mostly.  There are several uses for quantity limits - safety, waste, addiction prevention.  But even in other areas, there is a need for limitation - like how many days in a skilled nursing facility should produce enough recovery or expected recovery to be dismissed from this level of care.  A lot of people push this under Medicare Part A because they are old and neither them or their family have made any arrangements in pay or care for somebody to be there to help them for a while.  

If you want to control health care cost, we can look to what they do in other nations to hold down cost - but I do not think you would like some of what they do.