Medicare: Collision in care
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.
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.
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 a cell phone message.
Many Santa Cruz County primary care doctors refuse to see new Medicare patients, citing the low reimbursement rate they receive from the federal government.
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? Supplemental coverage?
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.
Dr. Nicholas Abidi moved west because his family wanted to be closer to his in-laws. But after leaving a large, successful practice in Philadelphia in 2000 to settle in Santa Cruz, he found the financial transition was anything but easy.
When Dr. Tony Musielewicz walks through Dominican Hospital's emergency room, he muses that it often "looks like a nursing home."
For the greater part of 2008, Dr. Chris O'Grady closed his doors to new Medicare patients.
He was already caring for so many elderly patients in his Watsonville-based family practice that he was often going home at 10 p.m.
Irene Tsouprake couldn't find a doctor for her elderly father. And it was starting to freak her out.
"Is he Medicare?" the administrative assistants would ask when she called. "Oh, I'm sorry. Our office doesn't take Medicare."
Jennifer Hastings didn't become a doctor to close doors. Her goal has always been to care for the down-and-out.
In Santa Cruz County, a storm is gathering: there simply aren't enough primary care doctors to go around.
Doctors aren't alone in providing primary care to patients. Increasingly, nurse practitioners and physician assistants have been sharing the workload.
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 anything wrong.
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