Every state will be slightly dferifent, but I'll give you the proverbial swine slap across the face about why Medicare is generally the worst thing invented by modern liberalism in this nation, in only ONE word: Access.In my state, there are 1,127 primary care Medical Doctors, and 130 Osteopaths in family practice. That's 1,257 doctors that handle routine care (non-emergency care, not otherwise in a named specialty).Of that 1,257, less than 11% accept Medicare assignment. CMS provides these figures, so my point is irrefutable. As others have noted, Medicare pays a fraction of an already deep discounted rate that is substantially below what providers call usual and customary (a fancy phrase for retail prices ).When a doctor refuses to sign up for Medicare assignment, they still get paid for treating Medicare patients, but they get EVEN LESS than the already bottom dollar (read: guaranteed loss) reimbursements of the doctors that willingly accept Medicare assignment. This is not my opinion. This is verifiable, irrefutable fact, and the source is CMS. Nobody knows better how bad Medicare is than Medicare itself.Of the several hundred doctors I advise in my practice, more than 95% go out of their way to refuse Medicare patients. Some go as far as sending out birthday letters prior to age 65 politely asking the patient to find another doctor (if you schedule an appointment after age 65, they aren't always so polite some instruct their staff to refer Medicare patients to CMS for the very short list of doctors willing to work for the absolute lowest wage a doctor can possibly earn).What this means to you is this: More than 89% of primary care doctors do NOT want Medicare patients, because they are guaranteed to lose money on those patients.What this also means to you is this: Private insurance subsidizes Medicare in an off the books fashion, via cost-shifting. Take away private insurance, and not only would Medicare go broke virtually overnight, providers would vanish faster than a modern liberal can fail at math (and they fail 100% of the time faster than any other group).Doctors aren't going to work for free. Neither will nurses, and other support staff (and you can't force them outside of a chattel slavery system of forced labor). They will all seek other ways to earn a living. This will lower access even further from the abysmal point it is now, and lower access ALWAYS equals higher costs, lower quality, and more early deaths among those modern liberals who failed at math so fast.Other points of interest: Largest and fastest growing form of crime in the USA is identity theft. Among that large group of crimes, the single fastest growing aspect is medical Identity theft. A Medicare card has a street value of $500 to $700 ten times that of a stolen credit or debit card.The second most profitable crime in America today? Medicare fraud. The source for that is the same government that built the failed collectivist system. The smart criminals are leaving the drug trade and turning to Medicare fraud. The numbers are staggering. A mid-level drug trafficker might make $300,000 a year, taking extraordinary risks. The same crook can make $30,000,000 stealing from Medicare, and never get shot at.Talent and capital go where it is rewarded, and stay where it is well treated. This axiom applies to the talent that goes into medicine, and it also applies to talent when it comes to criminals seeking to profit from the system that has ZERO financial incentive to fight fraud (ONLY a for-profit enterprise will root out the thieves, and find ways to detect them before they cause real damage the government just asks for more funding to replace what was stolen).

Kevin was very special to Elaine and me from the first sesshin we attended 6 or 7 years ago to the most recent a few weeks ago, when he came in during an evening sitting walking slowly with his cane and friends in support. I'll miss his humor and his dedication.

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Every state will be slightly different, but I’ll give you the proverbial swine slap across the face about why Medicare is generally the worst thing invented by modern liberalism in this nation, in only ONE word: Access.In my state, there are 1,127 primary care Medical Doctors, and 130 Osteopaths in family practice. That’s 1,257 doctors that handle routine care (non-emergency care, not otherwise in a named specialty).Of that 1,257, less than 11% accept Medicare assignment. CMS provides these figures, so my point is irrefutable. As others have noted, Medicare pays a fraction of an already deep discounted rate that is substantially below what providers call “usual and customary” (a fancy phrase for “retail prices”).When a doctor refuses to sign up for Medicare assignment, they still get paid for treating Medicare patients, but they get EVEN LESS than the already bottom dollar (read: guaranteed loss) reimbursements of the doctors that willingly accept Medicare assignment. This is not my opinion. This is verifiable, irrefutable fact, and the source is CMS. Nobody knows better how bad Medicare is than Medicare itself.Of the several hundred doctors I advise in my practice, more than 95% go out of their way to refuse Medicare patients. Some go as far as sending out birthday letters prior to age 65 politely asking the patient to find another doctor (if you schedule an appointment after age 65, they aren’t always so polite — some instruct their staff to refer Medicare patients to CMS for the very short “list” of doctors willing to work for the absolute lowest wage a doctor can possibly earn).What this means to you is this: More than 89% of primary care doctors do NOT want Medicare patients, because they are guaranteed to lose money on those patients.What this also means to you is this: Private insurance subsidizes Medicare in an “off the books” fashion, via cost-shifting. Take away private insurance, and not only would Medicare go broke virtually overnight, providers would vanish faster than a modern liberal can fail at math (and they fail 100% of the time faster than any other group).Doctors aren’t going to work for free. Neither will nurses, and other support staff (and you can’t force them outside of a chattel slavery system of forced labor). They will all seek other ways to earn a living. This will lower access even further from the abysmal point it is now, and lower access ALWAYS equals higher costs, lower quality, and more early deaths among those modern liberals who failed at math so fast.Other points of interest: Largest and fastest growing form of crime in the USA is identity theft. Among that large group of crimes, the single fastest growing aspect is medical Identity theft. A Medicare card has a street value of $500 to $700 — ten times that of a stolen credit or debit card.The second most profitable crime in America today? Medicare fraud. The source for that is the same government that built the failed collectivist system. The smart criminals are leaving the drug trade and turning to Medicare fraud. The numbers are staggering. A mid-level drug trafficker might make $300,000 a year, taking extraordinary risks. The same crook can make $30,000,000 stealing from Medicare, and never get shot at.Talent and capital go where it is rewarded, and stay where it is well treated. This axiom applies to the talent that goes into medicine, and it also applies to talent when it comes to criminals seeking to profit from the system that has ZERO financial incentive to fight fraud (ONLY a for-profit enterprise will root out the thieves, and find ways to detect them before they cause real damage — the government just asks for more funding to replace what was stolen).

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