Congress should pass legislation that imposes a tax on all services performed by a specialist. By imposing this tax, not only would it discourage citizens from receiving care from a specialist unless necessary, it would also create a large source of income that could be used to better fund Medicare and make it more accessible to those without health insurance. With the average cost per office visit to a specialist is roughly $81 as compared to $64 for a primary care physician (AAFP, 2010; Figure 3), a simple 2.5% tax could generate an extra $2 per office visit. In 2006 there were an estimated 66.6 Medical Specialty Office visits per 100 people and 59.8 Surgical Specialty office visits per 100 people (AAFP, 2010; Figure3). With the currently estimated population of the United States at 308,874,791 according to the US Census Bureau, that equates to 205,710,610 estimated Medical Specialty Office visits in the US in 2006 and 184,707,125 estimated Surgical Specialty office visits.
This tax would be applied by the government to all billings on services not considered primary care, which could then be passed on to the patient. This added funding would help the US ease the strain on the US budget and increase the money available for spending for Medicare. According to the Kaiser Family Foundation, spending for Medicare has grown at a slower rate than private insurance companies (KaiserEDU.org, 2010). If Medicare was more utilized, more Americans could have health insurance. The US government would be able to transfer that increased funding into either expansion for who is eligible for Medicare, which would in turn increase the number of Americans with insurance, public or private. This act would not only increase the amount of insured Americans, but by reducing the amount of uninsured Americans, costs would be reduced. Americans with insurance would not be forced to pay for uninsured Americans that still receive medical care. This would also reduce costs for insured Americans. This tax might also deter specialty care usage and promote primary care usage. If more Americas utilized primary care, more illness could be prevented, which would also reduced costs.
References
American Academy of Family Physicians (2010) www.afp.org. Accessed 3/14/2010.
US and world population clock. (n.d.). Retrieved from http://www.census.gov/main/www/popclock.html. Accessed 3/14/2010
US health care costs. (2010, March). Retrieved from http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358. Accessed 3/14/2010
Health insurance 2008 highlights. (2009, September 22). Retrieved from http://www.census.gov/hhes/www/hlthins/hlthin08/hlth08asc.html. Accessed 3/14/2010
Shi, L., & Singh, D. A. (2008). Delivering health care in America: a systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc.
Wow that is actually a really good idea, cuts down on waste and helps cover the gap of the uninsured and Medicare. I like it.
ReplyDeleteI'm surprised you like this idea. It's kind of "out there." Thanks for commenting!
ReplyDeleteThe idea is interesting; however, it also raises some questions. Who would be paying the tax? Would it be the patients themselves or their insurance companies? If the tax is included in the cost of care, then it would most likely be the insurance companies. Depending on how insurance companies handle the extra cost, patients may or may not realize what is being charged extra. Also, what about specialist services that are not as elective such as cancer treatments or care for chronic illnesses such as diabetes? Would these types of care be charged the same tax as someone who wanted to get an elective procedure such as rhinoplasty? (With that question I do realize there are also cases where rhinoplasty is not as elective, such as following a severe head trauma). I'm not necesarily disagreeing with this as a possibility - just trying to raise a few interesting questions.
ReplyDeleteI'm curious, how many specialists are out there compared to primary care physicians? Is the reason people go to specialists because there is better access to specialists? I think I heard that there are only roughly 35% of family practice physicians compared to the total number of physicians. How would you address the shift of more primary care patients, because I'm assuming you would need more primary care physicians and less specialists then.
ReplyDeleteI think it is a good idea in theory, but the extra two dollars would not be noticed by most people. If the goal was to really deter a patient from seeking specialist care unless it was needed, the cost would really need to be high enough that it would be noticeable. Once that point was reached, however, some patients might decide to simply not get the care they need.
ReplyDeleteAll in all, a very interesting idea to emphasize primary care and increase tax dollars to pay for our health care.