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The percentage of physicians donating charity care dropped from 76% to 72% between 1997 and 1999, says a study by the Washington, DC-based Center for Studying Health System Change (HSC).
The types of physicians most likely not to perform charity work were those working in a staff-model or group-model HMO and doctors who do not own their own practices, says the study.
"Policy-makers should take note that an important part of the health care safety net — physician charity care — is in danger of fraying," observes HSC president Paul B. Ginsburg. "If insurance costs continue to rise rapidly and the number of physicians providing charity care declines, access to care for the poor and uninsured will be in jeopardy."
Most indigent people are still getting medical care, the report found. However, with the supply of practicing physicians only growing at a 1% rate — compared to 3% in the 1990s — some experts wonder if there will be enough physicians available and willing to provide charity medicine.
"The proportion of physicians willing to provide charity care is shrinking, while demand for charity care is likely to increase if rising health care costs add to the ranks of the uninsured," says Reed.
The report cited these reasons for the trend: