A Disquieting Trend

I haven't been a very good blogger of late. I think it's because I've gotten into the mindset that every post has to be some literary work of art, or some tightly reasoned editorial. When we started this, it was a nearly daily afair, short pieces on subjects that struck our fancy. I'm going to try to get back to that.

In December, I saw a local (to Phoenix) news item that as of the new year, the Mayo Clinic in Arizona would stop treating (not just stop accepting new) Medicare patients. That put 3,000 senior citizens "on the street" for their medical care. The reason? Institutional reimbursement rates (not the doctor rate, but the hospital and clinic facility rate) were too low to be economically viable for the clinic.

You might say, "So what, Mayo is just probably too high cost, not representative," but you'd be wrong. The Mayo Clinic operates on the same model as the Cleveland Clinic - that's the one the President of the United States visited a while back to "prove" that costs can be kept under control while delivering the best of care.

This week we ran across another news item. Medicare rates for some elements of cardiac care (echocardiograms, for instance) were being cut back by 40%. That, the government said, was because a survey had indicated that the cost of such things had fallen by that much over the past decade. Cardiologists cried foul, and some are suing. That probably won't do any good, to what's going to happen? "We'll just have to stop accepting Medicare patients, or accept less," said one cardiologist. Another possibility raised was to close independent clinics and take such treatment into hospitals.

Come December I'll be on Medicare. With a heart valve prosthesis, I need periodic "echos." Will they be available? That appears less and less certain. Will I be able to find a clinic, a doctor? I'm no longer sure.

All that's without any of the similar cuts and changes included in the "reforms" pending in Congress. Tell me I don't have reason to be concerned.