In today's Times on page B-1, there's an article on the proposed plan to revamp MediCAL. In it, Jordan Rau used a very stupid quote from an equally insipid doctor who accuses any doctors not seeing the poor as being elitist, as having the ability to pay 10k to join some exclusive club. Boy, was that dumb.
I take exception to the gross stereotype that Hector Flores MD makes about physicians who are wary about the Governor's proposed health plan to help the poor. His accusation isn't true. Flores, who works in a 22-doctor group practice that more than likely has its share of administrative costs, probably doesn't even know the rent on his own very large, multi-doctor practice. I'm sure he's also completely unaware of the business challenges for solo practitioners, who by the way are just that: small business owners.
The truth is that all physicians want to see something done, however, the lack of true facts surrounding the proposal are many. For instance, in a recent radio interview with Larry Mantle, the Governor claimed doctors are getting 40 cents on the dollar from Medical reimbursements. This isn't true. They're getting anywhere from 10% - 20%, and most times they end up losing money because of the time consuming TAR process for authorizations that staff must devote.
The other truth is that physicians like Flores, who has 21 other doctors to act as support with their phalanx of medical assistants, PA's, administrators and receptionists have more resources to work with the MediCAL bureaucracy than solo practitioners. We have 2 full time employees and 2 part time. And here's more: we pay a living wage. So if it's the choice for me to take patients who pay more so that I can pay my employees something beyond minimum wage, then I do. And as a business owner, I make no apologies for this. But the truth is that large practices like Flores's can better handle the masses.
So how is the system going to be streamlined? Is MediCAL going to be able to raise its rates to the 98% that Schwarzenegger promises? (And yes, it's 98% because he's asking the doctors to contribute 2% of their gross --not their net, mind you, their gross, which in itself is crazy because what we bill is not what we get. This amount is predetermined by who else? Insurers).
Does this mean that Schwarzenegger is going to get rid of the middle man --that is the IPA's whose bureaucracies take off a huge amount for salaries? This is what we need to know. In the meantime, this office that I run continues to serve the poor in hospitals, often devoting many hours of the week to emergencies, follow up care, consulatations and referrals.
We will not be slammed by people like Dr. Hector Flores.