Ocare supporters trumpet that the repeal will remove 20 million people from health insurance. However, in 2016 only 12.2 million got the expensive insurance. This is a decrease from the 12.7 million the year prior and that was another disappointment to the regime. They expected almost 14 million in 2016.
There is a new drug for cholesterol, Repatha, that drops LDL to amazingly low levels. This would be a fantastic drug for many people with both high LDL levels and predispositions to heart attacks. It cuts the combined risk of heart attack, stroke and cardiovascular disease by 20%. It does have a a major drawback. It costs $14,000 per year. Insurers are loathe to pay for the drug and it takes an average of five requests by a physician to get it approved. About 75% of all requests are denied but then 50% of them are approved. To stop the hassle factor Amgen, the maker of the drug, offered insurers a refund of the cost of the medicine should patients have a heart attack or stroke while taking it. Only 5% of patients get a heart attack or stroke on the medicine. In a large study there also does not seem to be any significant safety risks to the medicine. This is contrasted with a generic statin which can cut LDL by half and reduce heart attacks by 25% but costs only $250 per year.
The VA still after all this time continues to disgrace itself. About 1/3 of the calls vets place to the suicide hotline are routed to outside centers. This is after opening a new call center. The VA should be dismissed in favor of Medicare for all vets.
Since Ocare has been up and running the time to see a physician in urban areas (large and mid size cities) has increased by about 30%. It now takes an average of about 24 days for an initial appointment except in Boston where the wait in this specialty and research heavy city is 52 days. Physicians that take Medicare is in large cities about 85% and 81% in mid size. Medicaid is 5 3% and 60%.
There now seems to be a greater probability of Anthem dropping out of Ocare in many areas. If they leave the market they would join United Health and Humana. Aetna has not yet made any decision.
Gavin Newsom, the frontrunner Dem for the California Governorship, is back at his progressive roots. He, while mayor of San Francisco, passed a law giving free healthcare to all that live in the county. To his credit he opened many clinics throughout the city but then put in place a law that is funded by not only the county but also by taxes on businesses. This tax is being funded by the consumer with add-ons for all restaurant meals. It allowed not only primary care for tertiary care as well including sex change operations. He is now pushing this statewide along with his early counterparts in SF. It will be interesting to see how this plays out under the possible repeal of Ocare, the liberality of California and the potential costs not only in taxes but potential loss of businesses in the state. Top
A study has shown that hospitals get a lot of money via their independent physicians. That is, if they provide convenience and communication which most don't. Patients know their rights and will go to the hospitals with the "best care". Independents give huge value to patient choice. About 7% of patients switch hospitals due to preference and communication. This is a loss of about $100 million per hospital.
One of Obama's shining lights when he touted Ocare was Mayo Clinic. Mayo has announced they will give preferential admission to insured patients over Medicaid or Medicare patients due to funding restrictions under Ocare.
Summa is back in the news again. This time 49 physicians signed a letter to the local newspaper stating their confidence in the ED physicians now at the hospital. This follows the ED nurses panning the ED physicians for dangerous healthcare. The physicians do not dispute the nursing claims and agree they should be investigated but they have not seen the same problems that the nurses report. The article does not state if the physicians are hospital employees or not.
Summa also was denied their appeal to allow their ED residency program to continue. The people who made the fateful decision to change ED physicians with no warning got their deserve. I do feel sorry for those who now need to find new programs.
Banner Health continues to downsize. They have laid off nurses and physicians and now have instituted a voluntary employee termination program hoping to save $65 million. Top
California courts have said that Monsanto should label Round-Up as a potential carcinogen. There was no scientific claim behind that ruling and European regulators have determined that the main ingredient should not be classified as a carcinogen. I would tend to believe the Europeans as opposed to the political courts of California.
Hospitals are continuing to use the Olympus scopes that have been recalled due to the inability to sterilize. There are about 4400 of these still in use. I hope they have great med mal insurance that covers punis. They will need it. Top
A new survey shows that 64% of physicians are not prepared for MACRA. The main reason is lack of budget and qualified applicants for the needed IT positions in organizations.
The anti physician company specializing in self aggrandizement has a new article out telling medical staffs to update bylaws so they can get the business. They make some valid points about very old bylaws not reflecting today's reality but their fear mongering assumes the medical staffs have not continually updated their bylaws. Top
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the