Collision in care

About this project

In the past two years, many of Santa Cruz County’s elderly and disabled patients have been shut out from a primary care system that has no room for them. Fed up with the low reimbursement rates paid by the federal insurance program for the elderly and disabled, many Santa Cruz County-based doctors have refused to accept new Medicare patients. The series investigates the breakdown in care and the prospects for fixing it.


Choosing Medicare coverage can be tricky

You've turned 65 and you're going to enroll in Medicare. Not so fast. The questions seem unending; the answers sometimes unclear. Do you want original Medicare or the Medicare Advantage Plan? How about prescription coverage?

Lower Medicare reimbursements plague county doctors

SANTA CRUZ -- Many Santa Cruz County primary care doctors refuse to see new Medicare patients, citing the low reimbursement rate they receive from the federal government.

MAIN STORY DAY 1: Collision in Care: Santa Cruz County's looming doctor crisis

Eighty-three-year-old Gladys Man steered her cherry red electric scooter into the Planned Parenthood clinic in downtown Santa Cruz. Inside the waiting room, nervous-looking teenage girls filled out medical forms; a young couple giggled quietly over...

Daughter is relentless in search for doctor for her father

SANTA CRUZ -- Irene Tsouprake couldn't find a doctor for her elderly father. And it was starting to freak her out.

Doctor faces gut-wrenching decision over patient care

SANTA CRUZ -- Jennifer Hastings didn't become a doctor to close doors. Her goal has always been to care for the down-and-out.

Doctor shuts door on new Medicare patients

WATSONVILLE - For the greater part of 2008, Dr. Chris O'Grady closed his doors to new Medicare patients.

ER doc: 'We're the safety net for everyone"

SANTA CRUZ -- When Dr. Tony Musielewicz walks through Dominican Hospital's emergency room, he muses that it often "looks like a nursing home."

Lower reimbursements force specialist to expand Santa Cruz practice to San Jose

SANTA CRUZ -- Dr. Nicholas Abidi moved west because his family wanted to be closer to his in-laws.

MAIN STORY DAY 2: Care for county's elderly reaches tipping point

Elderly and disabled patients are flabbergasted. Caring relatives are alarmed. Some doctors are conflicted; others are angry. And virtually everyone touched by Santa Cruz County's inability to care for its Medicare patients is frustrated.

HICAP helps seniors find primary care doctor

SANTA CRUZ -- Carol Fuller was approaching 65 and in fine health. The longtime Santa Cruz resident and former business owner had little reason to visit the doctor in previous years and relied mostly on annual visits to the gynecologist to catch...

Nurse practitioners, physicians assistants help provide primary care

Doctors aren't alone in providing primary care to patients. Increasingly, nurse practitioners and physician assistants have been sharing the workload.

Impact of "Medicare"

“Medicare: Collision in Care,” published Feb. 20, 2009, in the Santa Cruz Sentinel, examined the extreme shortage of doctors willing to take on Medicare patients in Santa Cruz County. In the aftermath of the series, local Congressman Sam Farr...


Jocelyn Wiener

Jocelyn Wiener is an Oakland-based writer for the Center for Health Reporting.

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