Practicing Medicine Just Got Harder - Forbes.com

Practicing Medicine Just Got Harder - Forbes.com: "When I heard that the U.S. House of Representatives had narrowly passed bill 3962, known as the 'Affordable Health Care for America Act,' I immediately thought of my old friend and medical mentor, Dr. Peter Berczeller, who had retired and moved to France back in 1992 to escape just this sort of change for the worse.

Berczeller saw it all coming. He retired just as the Health Maintenance Organizations were coming in. He had based his whole practice on providing a comprehensive unhurried service that the patient paid for. In Berczeller's day, it was actually the patient who had to apply for insurance reimbursement, not the doctor. Of course Berczeller's kind office manager, Marianne, helped his patients get their money, while the doctor concentrated on what he knew best, the practice of medicine."

But HMOs changed all that. Just as I was establishing myself in practice in the early 1990s, it became part of my daily routine to argue with insurance companies for payment.

As Berczeller boarded the plane for his little retirement villa in France, Medicare reimbursements continued to shrink, so that even though the public insurance program for the elderly was less restricted than the private HMOs, it was hardly worthwhile for a doctor to play ball with it.