July 15, 2011 Recent News




Kaiser Health News has a story about insurers buying physician practices.  It uses UnitedHealth but mentions Humana and Wellpoint.  This means tight care management and more people looking over the shoulder of the physician.  The story also tells of Cigna in Phoenix saving 9% with the physician group they own.  This means less tests and more hassle for the physician who wants to order the test.  Highmark has just purchased West Penn Allegheny Health System, a chain of six hospitals. 

Physician groups are experiencing higher turnover rates as more physicians want only part time jobs and the groups are fighting this new trend. A new survey showed that 13% of male physicians and 36% of female physicians ar working only part time.  

Utah has fewer physicians seeing their Medicaid patients.  This is due to the red tape and the pay.  The pool of physicians has shrunk 25% in 11 years.  This means only about one half of the state's physicians will see the patients.  The health officials have their heads in the sand and see no problem yet.  They must be politicians since they do not look ahead.  States pay about 72% of the Medicare payment which is not all that great. 

It's not just the states.  TriCare is having the same problems since the private carriers that administer TriCare patients bid for the contract and those that can save the government the most money under Medicare win the contract.  Then they have to find physicians willing to take the low pay.   

Becker Hospital Reports state that physician on call payments have increased 4% in 2010.   

The physicians of Puerto Rico have threatened to stop seeing Medicaid patients due to lack of payment by the intermediary insurance company, Medical Card System, Inc.  The government has withheld payments to the insurer until the bills have been paid.  The government also severed ties with the insurer.  The hospitals claim MCS owes them $91 million, the pharmacies state they are owed $6 million.  MCS blames the state by saying they have not been paid $243 million for services provided. 

To no one's surprise the liberal AARP are sending their representatives to Washington to make sure Medicare and Medicaid are not changed and will to under in the near future.  The American Seniors Assn. says that cuts should be considered.   

In an unbelievable story of red tape stupidity, the highest paid person on the California rolls outside of some University of California people is a surgeon who does nothing.  Dr. Jeffery Rohlfing has been employed at the High Desert State Prison but has not seen a patient since 2005 due to worries about his skills.  He has been assigned to occasionally mailroom work.  He was terminated in 2007 but appealed and won.  He received his back pay for the two years he was out of work plus his regular pay of $235,740 for a total of $777,423.  The prison has no choice but to continue to keep and pay him.  They will not let him near a patient.      Top


The law of unintended circumstances comes home again to roost.  This time in Colorado.  The wonderful high cost pre-existing condition insurance has very few takers in the state but the ones that do take it are running through the money at a rapid rate.  The state is so low on money that they may have to reduce benefits, put up waiting lists and/or raise premiums.  The state expected 4000 people to take the insurance but only 830 have.  Can you imagine what would have happenned if the 4000 took it?  Can you imagine the cost when Obamacare kicks in in 2014?   

The liberal New York Times has an editorial essentially stating that Medicaid and Medicare should be left intact during the current deficit debate.  They do not like Obama's proposal to take away $100 Billion from Medicaid as they feel it is only a beginning.  I have no idea and neither do they in the editorial where the needed cuts will be coming from.

The same paper has a blog regarding hospitals with and without physician CEOs.  They state based on one research paper from Bonn, Germany, that physician run hospitals have higher quality than those with suits at the helm.  The reason is simple suits look at money and then quality.  The reverse is true with physicians.

The San Francisco Business Times reports in San Francisco, California Pacific Medical Center and St. Luke's Hospital both owned by Sutter Health must do something to come up to earthquake standards.  San Francisco is a union city and the unions do not get along well with Sutter.  They have pressured the City to extort Sutter to pay about $2 Billion for permission to build.  Sutter is willing to pay $1.2 Billion but the result of the offer will not be known for a month or so.  It is amazing that the animus carries so far to hurt their own citizens. 

The New York Times has an article about how institutions and people rush to put out something new without thoroughly investigating the issue.  In this case cancer testing and especially Duke University.  

The People's Republic of Massachusetts is having more money problems.  It seems like every week of so another story about money problems surface.  This one is about the hospitals losing more money in 2010 than 2009.  It is predicted that some community hospitals will close and others will be purchased by the big boys. To make matters worse patients and physicians are both shedding the small hospitals for the bigger and better paying hospitals. 

California's Kaiser is doing well financially.  Their execs are getting good money and the physicians are earning good bonuses.  However, the Huffington Post says, the employees are getting wages cut and retirement funds reduced.  

Becker reports the takeover of medicine by the Obama denounced insurance companies.  The health insurers are buying up both physicians and hospitals.  United Health is the big player in the physician market as well as the hospital market.  Soon they will control the world.  

It should be noted that EMRs are not the only mismanaged electronic data base.  Foreign hackers got into the network of a defense contractor Lockheed and stole the files of 24,000 military people at a single incursion.  They also got into the records of another contractor Booz Allen Hamilton and stole 90,000 military emails and passwords.       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 information presented.