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Healthcare gap is widening - Harder for poor people to find a doctor

WILLIAMSBURG — A new report reveals that when it comes to access to health care, the rich stay well and the poor get sicker.  The Lou RossiterSchroeder Center for Healthcare Policy at the College of William & Mary released grim results from a survey on access to physician care in greater Williamsburg. 

Poor people on Medicaid or without insurance have the most difficulty getting access to a doctor. But patients with Medicare or private insurance have little problem finding care. In fact, Medicare patients here have among the best access in the nation.

The survey canvassed 1,125 people and was targeted to underserved areas identified by the Virginia Department of Health. The Williamsburg Community Health Foundation funded the survey through a grant.

“The study found that parity in access to doctors is not a characteristic of greater Williamsburg,” said Louis Rossiter, director of the Schroeder Center, in a statement about the findings.  “Anecdotal comments are made by local people in greater Williamsburg about personal difficulties in accessing doctor care. The survey confirmed the anecdotes. [It] found that the problems are not in certain geographic areas, but are concentrated among those with Medicaid or no health insurance at all.”

Supporting the findings is a Gazette report from June about how Sentara Medical Group opened up 1,000 new Medicare patient slots with local doctors. Nine months after the announcement of the program, barely 100 patients had been placed with doctors. Critics have since said Sentara required too many strings to make it practical for some patients.

The Schroeder study found that those without health insurance face big problems.

  • Nearly 60% of the uninsured lack a regular doctor.
  • Just 25% of them could get access to a specialist. 
  • Almost half of those without insurance had difficulty obtaining routine care.
  • More than 59% had trouble getting urgent medical attention. 

In contrast, the survey revealed that 86% of those in greater Williamsburg have a relationship with a personal doctor.

Christine Jensen, an investigator on the W&M Schroeder Center study, said that national estimates are that 1 in 3 doctors is not accepting Medicare patients.  “The primary reason for not accepting new patients or limiting services in greater Williamsburg is inadequate reimbursement for Medicare and Medicaid,” Jensen said. “But Medicare billing and regulatory requirements are also given by doctors as a common reason.”

The future could become more difficult for Medicare patients. In late 2006 Congress rejected a plan to cut Medicare fees 5%, instead freezing payment fees for a year.

The American Medical Association projects a 10% reduction in reimbursements in 2008 and 40% reductions over nine years. Adding to the problem was an AMA survey released in June that said 77% of physicians would likely limit the number of Medicare patients they would accept, blaming pending cuts in reimbursements.