The Untold Health Care Story: How They Crippled Medicare

Until recently, my husband and I had been seeing one of those “Oh-I’m-so-glad-he’s-my-doctor” physicians for two decades. Then one day the mail brought the announcement that the office was closing its doors and that the four doctors who had been in the practice were either retiring or leaving San Francisco. They enclosed a list of doctors who, they said, had indicated they had room in their practices. So started my search for a new primary-care physician.

I looked the list over, saw a familiar name, and dialed the number. “Yes,” the receptionist assured me, “doctor is taking new patients.” It was all very friendly; I made an appointment; she set about recording the necessary information, and then the crucial question. “What insurance do you have?” “Medicare and AARP” (one of the several medi-gap insurance plans to which those of us who can afford it subscribe), I replied. I heard a small intake of breath, a ten-second silence that felt like much more, and then, “Oh, you should have told me before that you’re Medicare; doctor isn’t taking new Medicare patients.” And with that she severed the connection and, I assume, wiped my appointment off the book.

I was surprised at the brusque refusal, shaken a bit, but not yet worried. San Francisco is a city that seduces with its charms, and with a major medical school within its borders and two more less than an hour’s drive away, we have plenty of well-trained physicians practicing here. How hard could it be to find a good internist? Very hard, it turned out, as I worked my way down a list of a dozen doctors—some referred by my retiring internist, some recommended by friends or friends of friends.

Since the medical community in the city knew of the shuttering of the office where I’d been cared for, they were prepared for calls like mine. Some announced on their voice mail: “The doctor isn’t taking any new Medicare patients”; some asked the fatal question about insurance before responding to my request for an appointment; and a few waited until they had noted all my personal information before asking the question. Twelve calls; twelve refusals to take Medicare.

Stunned, I sat at my desk looking at the list and wondering, What happened to the Medicare I once knew, to the physicians for whom it was simply another part of their practice, to the government that once supported it fully before the right-wing mania for privatization set in? Big questions. But my immediate concern was to find a doctor who would be available when my husband or I needed her or him.

Because I’m reasonably well-known in this community, I decided to get past the front desk by writing to each of these physicians directly. I laid out my credentials and accomplishments as if I were applying for a grant or a job; I dropped some reputable names of people, lay and professional, who had given me permission to do so, while at the same time assuring the doctors ...