Tuesday, March 08, 2005

The Maryland Scam

So, instead of implementing the famous Medical Malpractice Savior Bill that we had to have a special session of the legislature to pass (in the week after Christmas 2004) and a veto by Bobby Ehrlich and an override by the leg, we now have to have an "implementation" bill before we get some financial relief.

I'm holding my breath.

But wait! There's more. Much ballyhooed in this legislation was an increase in Medicaid payments to physicians. I was all in favor of this until I realized who the physicians were.

Here's the language:
16 (ii) in fiscal year 2006:
17 1. $40,700,000 to the Rate Stabilization Account to subsidize
18 agreements for calendar year 2005; and
19 2. $39,300,000 to the Medical Assistance Program Account;

Well, who are the physicians in the Medical Assistance Program?
It includes obstetricians. This is o.k. In fact, this is great because they are experiencing the brunt of the malpractice crisis.

But, according to the "implementation" bill now before the legislature in Annapolis, the only other specialties that are going to get a payment boost are:
Orthopedic Surgeons
Emergency Medicine Physicians

The reason for this is that Orthopedic and Neurosurgeons won't take Medicaid patients because the reimbursement is so poor. In our area there is a monopoly of orthopedic surgeons and they can stonewall on Medicaid. (For a while, we had to send kids 50-60 miles away just to get a fracture set. This is not a good thing when I can spit out my door and hit the local orthopedic office.)

And orthopedic surgeons are very well compensated. One estimate of their annual salary is $354,495. This may be five times what a pediatrician or family practice doc makes.

But family practice and peds aren't going to get any relief because orthopedic surgeons are starving to death. Give me a break.

I am sorry, but "fixes" like this drive many of us up the wall. It used to be fun to practice medicine. It is rapidly becoming a job few people want (unless, of course, you are an orthopedic surgeon).

Everybody wants quality medical care. Pretty soon, only George Bush and Co. will be able to afford it.

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