SAN DIEGO: Doctors, Nurses Rally to Protest Low Reimbursements
In an event touted by the San Diego County Medical Society as "the largest organized protest by area physicians in history," several local doctors, nurses and hospital officials are rallying in San Diego today to protest declining health care reimbursements from government agencies and managed care programs. The San Diego Union-Tribune reports that representatives from the California Medical Association, area hospitals, the Chamber of Commerce and the Board of Supervisors are slated to speak at the "Code Blue" protest. The San Diego Medical Society, which is sponsoring the event, reported that the demonstration is meant to "dramatize its view that underfunding health care costs is affecting patient care." Society President Dr. Ed Singer said he realized that California had overall low spending rates on Medicare and Medi-Cal, but objected to what he called "a third person in every exam room, someone who tells the doctor how to practice, what tests to order and what drugs to prescribe" (San Diego Union-Tribune, 10/25).
Capitation -- the Death of the Medical System?
In an accompanying Union-Tribune editorial, Singer writes: "[M]anaged care and especially the HMO payment scheme known as capitation has gutted the medical profession and the delivery of health care," resulting in a health care system that "is in a crisis, with physicians and patients bearing the brunt of the severe underfunding of health care at all levels." Capitation is a system in which a physician or other medical provider is prepaid for medical services at a set amount per month regardless of the level of care needed by the patient. Singer describes this system as "flawed," especially in California, where capitation rates are "lower than the rest of the country and just plain do not cover the cost of care." In addition, Singer argues that capitation poses a "financial risk" to medical providers, since a patient may require "intensive and expensive" care to treat conditions such as life-threatening illness or "catastrophic accidents." Singer maintains that this "problematic model" of funding health care is "decimating medical groups" and causing many to fail. Under today's health care system, "[d]octors and their patients have become commodities; units to be bought and sold, with one the same as the next in the eyes of the few for-profit HMOs which dominate the market." Even though "there is no easy solution" to the problem of the health care system, Singer concludes, "[P]atients and employers, who foot the bill for the majority of San Diego's private insurance, need to understand more about how health care is financed and how underfunding has a direct impact on their choices and their care" (Singer, San Diego Union-Tribune, 10/26).