Remember in the beginning of the year when the lying administration and CMS said that primary care physicians taking care of Medicaid patients would be paid Medicare rates for the care. Well, the second quarter of the year is over and the physicians are still waiting for their pay. This is only a two year deal and the physicians are getting screwed by not only losing the money to date but also will not be paid any interest on the money owed.
The WSJ reports that since 2009 the number of physicians that have opted out of Medicare has tripled. There are now almost 10,000 physicians out of Medicare and one third of the country's physicians have opted out of Medicaid. Top
California is very far along the road with Obamacare except for one small detail. They have no physicians to care for the patients. Only 16 of the state's 58 counties have the federally recommended amount of physicians. Another detail is that 30% of physicians are at or near retirement age. As the curse of Confucius states " May you live in interesting times."
The left leaning California Healthline states that moderate and conservative Democrats are going away from Obamacare. The poll showed those favoring the morass fell from 78% to 48%. Those who self identify as liberal Democrats continue with the 78% favorable rate.
In California the exchanges are hiring people to help enroll people for Obamacare. The people hired (in Contra Costa county 7500 people applied for 250 jobs) are now finding that they are part time workers and are not eligible for the Obamacare they are working for.
Maryland has said it's exchange premiums will be cheap. They are right. A 21 year old non-smoker will be able to get health insurance for $97 per month. If you want more comprehensive insurance it will cost more. Maryland is a state that give it's regulators the ability to control premiums charged by private insurers. However, even this low price is higher than one would pay this year without the mandated benefits, $62. The $97 plan would cost $174 in California.
Physicians are fairly confident that Obamacare will not happen on time, that is if they even know what Obamacare is. Most physicians do not know how the exchanges will pay them, patient coverage or plan benefits. If this thing actually comes into being it will affect physicians directly and they will be in the dark.
White Castle is starting to hire only part time employees in preparation for Obamacare. They will not fire their full time employees. Top
Sutter Health in California has put in the Epic system. This system was booed significantly by the physicians and nurses at Contra Costa Hospital when it was introduced there with the complaints that it caused harm to patients. The Sutter nurses are now echoing those original complaints. The hospital denies any problems and blames the complaints on the nurse's union. It is in the process of being put into place at John Muir Health so it will be interesting to see if there are any complaints from the staff there.
In the AHLA listserv is a post about an unnamed for profit hospital that is probably in the area of Port Charlotte, Florida, that has an EMR that they developed and instituted without any input from the medical staff. After three months in which the hospital passed the meaningful standard and got its money the medical staff said the program is dangerous to patient care and is now refusing to use it. The hospital will not change the program nor consider using a different one. The staff is apparently on two other hospital staffs in the same locale. They may show their disdain by walking their patients to the other hospitals. This may be a symptom of more problems between the administration and the medical staff but in any case it should cost the administration millions of dollars either in loss of income or loss of meaningful use money as well as the need to change systems.
CMS states that 80% of the hospitals and 58% of the physicians eligible for EMR money have received it. Hospitals have received about $9.4 billion up to June. The physicians have received about $6.3 Billion. The numbers are skewed however. The hospitals that have received the money number 4024 while the physicians number 305,778. Top
In a massive waste of taxpayer's money, a new VA hospital has almost risen in Aurora, Colorado. The builder has asked to quit the project since it is now over $200 million over budget due to what he describes as mismanagement and bungled designs. He wants the project to be either down sized or get more money from Congress which means the taxpayers since Congress has no money. The VA is blaming the contractor. This is another example of how the VA system is a drain on the taxpayers. Again, the VA should be disbanded except for specialized rehab and all others be put into the Medicare system.
Did you know there was an outbreak of Legionnaire's Disease at the Pittsburgh VA which included at least five and maybe six deaths. When asked about it this week, the VA would not respond. The VA undersecretary of health only looked straight ahead when asked about the deaths and the lack of oversight and refused to acknowledge the question. Another example of the wasteful non needed and maybe dangerous system.
Did you know about the 340B program. I read about it in a recent article in the WSJ. The program was originally set up to help pay for drugs for uninsured and indigent patients. Obama has now bastardized the program so many hospitals are buying oncology practices just so they can buy drugs at half price via the program but sell it to patients at full price. This increases the cost of care for all. The hospitals are now putting the revenue from the drug buying program which may be over $1 million per year into their general funds instead of to help the uninsured as originally intended. Obama is doing nothing to oversee the program and the hospitals stealing legally from it.
Obamacare has had the effect of hospitals focusing on patient satisfaction. That has nothing to do with quality but satisfaction. Satisfaction gets money for hospitals, quality does not. This comes from an article in the LA Times. I had the personal misfortune of visiting a local ED two weeks ago. I was pleasantly surprised at how quickly and efficiently the process was as well as how pleasant the staff and the physician was. They got a great review from my wife on their Press Ganey scores. I received another Press Ganey following a visit to my primary care physician. It, and the hospital questionnaire, had to do with my perception of the office staff, wait times etc. Quality of care was never included, but it was also first rate.
The Bloomberg Report states that some rural and inner city hospitals are now laying off staff due to the AHA agreeing to a $155 Billion cut in payments to promote Obamacare. The money would have come from more patients but that may not happen and the sequestration took an additional 2% away. The Supreme Court's decision regarding Medicaid also hurt the hospitals. Some Democrat legislators are backing bills to let certain hospitals get the money promised. These have no chance of passing. Top
In another blow to California exchange system, Anthem has pulled out of the state's small business exchange. It had previously pulled out of the large business exchange. They will continue with individual policies in the exchange.
CMS is planning on spending about $700 million to promote Obamacare because many people believe it is not the law, that it was repealed by Congress or that the Supreme Court had said it was illegal. These people vote.
Wellpoint has said that it is seeing small business start to drop health insurance so their employees may get on Obamacare. This was seen several years ago by all but Sebelius and Obama.
The LA Times has an article on the fast rising rates of insurance by Kaiser. The rate of increase has far surpassed Blue Shield or Blue Cross. The employers are stuck since Kaiser has been such a large percentage of their coverage in the past due to low cost and employees do not want to change physicians. 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