How was your experiences dealing with Medicare?
Honestly, I have mixed feelings on this. On the one hand, unlike traditional insurance companies, they were quick to pay for services and didn't often question medical necessity.
On the other hand, I lost money on most medicaid patients that walked through the door. The reimbursement rates were so low that after I paid staff, supplies, and overhead, there was nothing left. This is one of the reasons many physicians over the past 20 years have stopped taking government payment (Medicaid, Medicare, TriCare, etc.). It just doesn't pay the bills.
There is the argument that if you have less staff in a universal payer system, that you can make up for this downfall. But even if I was not paying front office staff, a biller, a coder (terminology for the person that helps the biller determine what was done and is billable services), a medical assistant, and a nurse, it would still be tight.
I won't argue that 1/2 my staff would be un-necessary in a single-payer system, and I always had reservations paying someone for work that added un-necessary complexity to the system, but it was the system that I had to work within.
I once considered going 100% concierge, and not even having an office but going to my patients. I would have had no nurse, no staff, no insurance to deal with, and could have spent a lot more time with my patients. It would have also likely been cheaper for the patients. About the same time I considered this, my side business became my main job, so I never pursued it further.
