In a 4/17/09 WSJ oped, Marc Siegel, an internist and associate professor of medicne at the NYU Langone Medical Center, notes a 2005 Community Tracking Physician survey showing that only half of doctors accept Medicaid. He cites a 2008 Medicare Payment Advisory Commission report that “28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24%” in 2007. A Texas Medical Association survey in 2008 found that only 38% of doctors took new Medicare patients.

My mom’s primary care doctor, who has been in the field for 40+ years, made the comment that many younger doctors specialize because it pays so much more than primary care. As the baby boomers age and need more medical care, there simply will not be enough primary care physicians to handle the load.

Medicare’s payment schedule for medical services penalizes doctors who emphasize preventative care. Medical professionals are paid more if a patient has a heart attack than taking steps with the patient to reduce the chances of a heart attack. Because of its size, Medicare’s philosophy and reimbursement approach dominates the entire field of medicine.

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