And wondering if my healthcare options are diminishing with age
By Susan Braudy
A poisonous cloud hovers. The literally sickening gap between the very rich and the rest of us in New York City is widening as you read this sentence. I am singularly blessed with a rich, generous brother—who’s been there for me in a medical pinch. Otherwise, my health and life span might have been compromised.
It turns out that many of the best, snootiest New York doctors are refusing to settle for Medicare fees, dangerously widening the healthcare gap. Several of our finest so-called caregivers fired me when I joined Medicare because they said the fees that Medicare pays just weren’t high enough.
Why can’t the government make it illegal for rich doctors to either fire or insist on full fees from Medicare patients? This feels so cold-hearted for patients, such as myself, who’ve been cared for by these doctors for years.
The mess isn’t as sickening as the hordes of doctors opting out of Medicaid, a tragic story that hit the front page of the New York Times, but it’s pretty icky.
Dr. Carlin Vickery was the first doctor to present the bewildering Medicare facts to me in her orchid-decorated upper Fifth Avenue office. She simply charges much more than Medicare would reimburse her. Some of our finest doctors—indeed the finest on earth, such as breast surgeon Alisan Goldfarb—have not opted out of Medicare. But Dr. Goldfarb’s an exception; her Medicare fee is 10 percent of her normal operating fee. Another hero is my world-class cardiologist Dr. Martin Post, who diagnosed a symptom-free David Letterman as having a dangerously weak heart. (“He has a seventh sense,” says my neighbor Mara Gardner. “He senses the heart.”)
I know the sad story backward and forward. For the past decade at least, Medicare has reduced fees to shrinks, for example, by 5 percent a year, refusing to consider advancing inflation and rents. This year, Congress voted to reduce fees by 23 percent, then put the decision on hold. Dr. Ann Dolinsky, a superb psychiatrist, is the only one I know who has not terminated her Medicare patients.
I don’t know whom to blame. But holy smokes, I’m scared.
I think New York magazine’s list of best doctors should note whether they take Medicare. The latest doctor to opt out on me is Dr. Miriam Levy, of Medical Imaging of Manhattan, who I’m told is the best in the business. If I want a bone density scan from her office, which I’ve patronized for two decades, I must pony up $400 (loyalty is not an issue). I must say I’ve noticed a certain parsimony and indifference to patients’ time in the way this office is run. I’ve sat three hours waiting. The reason, I was told, is to insure that machines and technicians are used as much as possible.
Dr. Jesse Rosenthal, psychopharmacologist, announced that he’d fire me when I reached Medicare age. He told another doctor he doesn’t like treating older people. Dr. Andrew Martorella, an endocrinologist, is one doctor I continued to see for a year after he suddenly decided to refuse Medicare insurance.
Why the hell can’t the government’s Medicare insurance match insurance payments from private companies? Another solution: Why can’t Congress at least set up a sliding scale of payment, based perhaps on patient income, allowing patients to reimburse doctors and to at least match fees paid by private insurers, thus compensating doctors a bit better for their vital work? Will the government’s new healthcare plan pay too little for many doctors as well? Help! n
Susan Braudy is the author and journalist whose last book, Family Circle: The Boudins and the Aristocracy of the Left, was nominated for a Pulitzer by publisher Alfred Knopf.