If You Pay It They Will Come
A depressing look at why Medicare is a trainwreck waiting to happen and what occurs when you allow people to have unlimited access to health care without any cost consequences (hint: they become hypochondriacs):
Doctor visits have become a social activity in this place of palm trees and gated retirement communities. Many patients have eight, 10 or 12 specialists and visit one or more of them most days of the week. They bring their spouses and plan their days around their appointments, going out to eat or shop while they are in the area. They know what they want; they choose specialists for every body part. And every visit, every procedure is covered by Medicare.
Boca Raton, researchers agree, is a case study of what happens when people are given free rein to have all the medical care they could ever imagine. It is also a cautionary tale, they say -- timely as Medicare's fate is being debated in Congress -- for it demonstrates that what the program covers, and how much it pays, determines what goes on in a doctor's office and why it is so hard to control costs.
South Florida has all the ingredients for lavish use of medical services, health care researchers say, with its large population of affluent, educated older people and the doctors to accommodate them. As a result, Dr. Elliott Fisher, a health services researcher at Dartmouth Medical School, said patients have more office visits, see more specialists and have more diagnostic tests than almost anywhere else in the country. Medicare spends more per person in South Florida than almost anywhere else -- twice as much as in Minneapolis, for example.
But there is no apparent medical benefit, Fisher said, adding, "In our research, Medicare enrollees in high-intensity regions have 2 to 5 percent higher mortality rates than similar patients in the more conservative regions of the country.
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