ObamaMESS: Health care Monopoly driving Doctors Out of Business

Single-payer advocates promise high-quality low-cost health care for all.

But physicians in Vermont say the state’s move towards a single-payer health care system is driving independent doctors out of business and eliminating patient choice.

“The health systems have caused it to be nearly impossible from a financial standpoint to stay in private practice. That’s not so in the rest of the country,” Dr. Paul Reiss, a Williston family practice physician, told Vermont Watchdog.

Dr. Paul Reiss, a family physician in Williston, Vt

“We’ve gotten to a place here in Vermont where we have about 20 percent independents, yet in the rest of the country 50 to 60 percent are independent practice.”

According to Reiss, the dwindling number of independent doctors in Vermont is due in part to underpayment from government health care programs.

“You get paid for the work you do if you participate with Medicaid, but they pay you considerably less than commercial payers like Blue Cross or MVP, and typically less than Medicare as well. So for the same services you get less.”

Reiss said underpayment is making it difficult for doctors in Vermont to balance their budgets, hire support staff and fund basic operations.

Dr. Ernest Bove, a urologist from Rutland, VT

Dr. Ernest Bove, a Rutland urologist who has served patients for 29 years, said underpayment from Medicare and Medicaid is hurting specialists, as well.

“Reimbursement rates make it very difficult for a specialist practice to survive in Vermont. That’s why physicians are joining hospitals and becoming employees. They can’t run a business anymore,” he said.

“Reimbursements have been flat for years and have even gone down in many instances. And your expenses keep going up. I estimate a 5 percent cycle of inflation every year in terms of electrical costs, which are already high, and I’m paying $3.50 for heating oil, so that’s high. But the reimbursement rate remains flat. Plus your employees need a raise. You just can’t stay alive. That’s why people are leaving.”

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