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More financial pressure on primary-care physicians

Medicare, with the complicity of the American Medical Association, has increased the financial pressure on already-pressured primary-care physicians. At least, so says The Health Care Blog.

According to the blog, Medicare's payment structure (and those of many private insurers whose pay structures closely parallel Medicare's) is largely rigged by specialists in favor of specialists despite research indicating that more emphasis on primary care leads to lower health-care costs overall.

It's a self-worsening problem: As financial pressures on primary-care physicians increase, more PCPs get out of that line of work and fewer new physicians enter it. That means a relative increase in specialists, with their higher fees, to handle patient care, with more specialists thus involved in the process by which fees are set.

Read the whole thing -- it's very easy to understand. Unfortunately, it's not a very optimistic piece. Among other things, it points out that Congress would have to act to get Medicare to change its ways (that is, reduce the role of specialists in helping it set its fee structure, if I understand correctly), and as I've pointed out elsewhere in other contexts, expecting Congress to do the right thing by the average person (or small employer, on whom the greatest health-care expense burden falls) is becoming more and more a sucker's bet.

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