U.S. PHYSICIANS Survey: Fewer give free care to poor

The findings failed to surprise the president of the AMA.
WASHINGTON (AP) -- The percentage of physicians who provide free care to the poor has dropped over the past decade, signaling a growing problem for the uninsured, a survey suggests.
About three-quarters of physicians provided charity care in the mid-1990s, compared with about two-thirds now, according to a study being released today by the Center for Studying Health System Change.
The numbers have declined across all major specialties. The highest rate of free care, 78.8 percent, comes from surgeons, perhaps because many of these doctors treat uninsured patients in emergency rooms.
A little more than 60 percent of pediatricians provided free care, the lowest rate among the specialties. That could be because children are more likely than adults to have insurance coverage.
Trends responsible?
Dr. Peter Cunningham, senior researcher for the center, said he thinks the drop in charity care reflects two trends:
Ustagnant reimbursement rates from the government and lower fees that insurers are negotiating on behalf of their customers.
"In the past, a lot of physicians were able to afford it because they could charge paying patients higher rates," Cunningham said.
Umore physicians are leaving solo practices to join large group practices.
"This means they have less control over the types of patients they see," Cunningham said.
The president of the American Medical Association said he was not surprised by the findings. Dr. J. Edward Hill, a family physician from Mississippi, said doctors are committed to providing charity care, but many are constrained by time and finances.
He noted that the average doctor completing residency has about $119,000 in debt.
"Charity care is not the solution to our health coverage problems in this country," Hill said. "Maybe this will help wake up everybody so they understand we've got to solve the problem of almost 46 million people without [insurance] coverage."

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