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GEN: System on the BrinkFrom: art fougner, md (evsono@pipeline.com)Mon Oct 30 08:16:08 2000
San Diego doctors say healthcare system is in crisis Last Updated: 2000-10-27 18:01:40 EDT (Reuters Health) By Karen Pallarito WESTPORT, CT (Reuters Health) - Chronic and severe bleeding of the healthcare system is threatening the delivery of medical care in the cradle of managed care, physicians warned yesterday. Some 500 San Diego-area doctors, nurses, healthcare system leaders and elected officials rallied on Thursday to spread the word that inadequate funding has forced dozens of physicians to flee the market and pushed many medical groups to the brink of bank ruptcy. "As a result of underfunding at all levels, the doctor-patient relationship is at risk," declared Dr. Robert Hertzka, immediate past president of the San Diego County Medical Society, which organized the gathering, in an interview with Reuters Health. In conjunction with yesterday's event, the medical society released "Healthcare at the Crossroads: A Code Blue Report on the Status of Healthcare." Physicians and other healthcare providers "have borne the brunt of managed care and low governmental reimbursement" despite advances in medical technology, according to the report. The report says that Southern California, especially San Diego, "has been on the cutting, or many would say bleeding edge" of the healthcare crisis. "At a time when San Diego's economy is booming, our healthcare system stands at a crossroads between fulfilling its promise and falling apart," it contends. Hertzka ticked off numerous financial pressures that are squeezing the system. Capitation rates that doctors receive for seeing managed care patients, for example, are lower in San Diego than in the rest of California and most of the nation. Average Medicaid spending per patient in California ranks far below that of New York, he added. And despite a booming local economy, quality medical groups can't recruit new doctors, who can make twice as much money in places like Boulder, Colorado, Hertzka said. "The word is: Don't come to San Diego--The sunshine's not worth that much," he said. "The health plans in California understand and agree with the fact there's a huge strain on the system right now," said John Schneider, health economist and director of research at the California Association of Health Plans. "A lot of money has been taken out of the system over the past 5 years mainly because private purchasers and government don't want to pay as much as they have in the past," he told Reuters Health. "What you see in San Diego...is an overt expression of what that strain is," Schneider explained. On the other hand, he said that some of the assertions in the medical society's report are untrue. There's as much if not more consolidation among medical groups as health plans, he said, refuting the contention that health plans in Southern California enjoy unusual market dominance. And while there's no doubt that the number of physician groups and independent practice associations are closing or going bankrupt, "what there's a need for is a careful analysis of why that is happening," Schneider said. A lot of physician groups are not forthcoming about their financial data, he charged. While physicians took to the street, the business community's lead advocacy group on Thursday was addressing elected officials, members of the healthcare industry and business leaders on the financial pressures facing the entire healthcare community. "We are sympathetic to both the hospitals and the doctors," Mitch Mitchell, vice president of public policy at the San Diego Regional Chamber of Commerce, told Reuters Health. "The state of healthcare in all areas is a tremendous concern for the Chamber,'' he said. The Chamber itself is facing 13% and 15% increases in the rates charged by its HMO and PPO, respectively. Meanwhile, it's getting harder for employers to afford to provide health benefits, he said. The Chamber hopes to persuade elected officials to do something about low state and federal reimbursement rates, unreimbursed care and state mandates that boost the cost of healthcare delivery, Mitchell noted. -Westport Newsroom 203 319 2700 as we eagerly await the results from 11/07/2000 - stay tuned. art
-- art fougner, md
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