Medicare: heading toward a crisis

Implications: The aging population, coupled with per capita decreases in Medicare spending, threatens the entire health care system. Here's why.

Analysis: Unlike the 20-40% number quoted in this article about Oregon, my practices proportion of Medicare patients is 55% in semi-rural Montana. As Medicare goes, so goes the rest of the system, and the outlook isn't good. With Medicare accounting for such a high proportion of rural medical practice payor mixes, the viability of our healthcare system is at stake. With more physicians creeping toward retirement age, and with their patient population doing likewise, it is only a matter of time before a mass exodus of physicians occurs. The heyday of medical practice has come and gone. Lean times are ahead, as Medicare barely provides breakeven revenue. Why work twice as hard to merely break even? I could work half-time, cut loose my Medicare patients, and make the same net income. This same economic decision-making, occuring on a national scale, is what could uproot our system.