TO ACCEPT OR NOT TO ACCEPT: MEDICARE PATIENTS

BY HAMZAH ALI – When deciding upon a career in medicine, the expenses of attending medical school crosses every student`s mind. Students aim to obtain the best residency in order to earn high salaries that can pay off accumulated loans. An important question for medical students to consider moving forward in their career is “Who/what is paying my salary during residency?” If it was not for Medicare, residents would be without pay. Yet, many of these residents, later in their career, will go on to deny care to thousands of Medicare-insured patients.

Under the Social Security Act of 1965, Lyndon B. Johnson established Medicare. It provides health insurance to citizens above 65 years of age who have worked and paid payroll taxes. It also covers those who have End Stage Renal Disease and individuals claiming disability. Medicare has 3 main parts: Part A covers hospital and hospice services, Part B covers outpatient visits, and Part D covers prescription drug costs. In the Annual Report of Medicare Trustees, it was reported that Medicare provided health insurance for 55 million people in 2015. Individuals in this pool are at risk of receiving unequal care or being flat out denied healthcare.

The majority of Medicare recipients, if not all, have been wrongfully promised that if they pay their taxes, they will receive subsidized healthcare in their old age. Innocent people are caught in a battle between the federal government and healthcare professionals. Reimbursements to physicians are almost 50% lower, so they simply deny patients whose only source of medical insurance is Medicare. Who is at fault for this neglect? More importantly, what is the solution to this problem? The institution overseeing Medicare is responsible for the issues that have risen since its creation. To put into a simple analogy, Medicare is a boat and the issues are holes that have formed in the boat over the last few decades. Instead of fixing the holes, they were plugged for a short term with hopes that they would no longer be problematic. At the same time, individuals were being allowed onto the boat because they met the eligibility requirements. Now, the boat is reaching capacity and is slowly sinking because the pressure caused the holes to be problematic again, except now it is at a larger scale.

It would be impractical to suggest that physicians should accept all Medicare patients because self-interest is a factor too deeply ingrained in already practicing physicians. However, a solution involving medical students and residents might be worth exploring for the future. They should be conditioned at an early stage in their medical education to provide equal care to every patient. Medical students should be required to continue volunteering in their communities, both in medically and non-medically relevant experiences. This will help instill values of service and altruism in future physicians. Physicians that are exposed to these principles will more likely be considerate and not let self-interest guide their decision on accepting Medicare. Residents should be reminded that their salaries come from Medicare; there should be an understanding among residents to pay back what they have earned by seeing patients who are covered by Medicare. Imagine receiving a scholarship to an undergraduate institution and banning the scholarship years later. It seems counterintuitive.

The Baby Boomer Generation is causing healthcare costs to spiral upwards. They require more medical visits and services than any other age group. To maintain stability, patients, physicians, and the federal government must cooperate to prevent significant losses to our healthcare industry. Through joint effort, the holes in Medicare can be fixed and upgraded to fit our aging population`s needs. Through awareness and understanding of why and how Medicare works the way it does, both current and future physicians alike will begin to view it with a more positive outlook.