June 15, 2010 Recent News
The New York Times had a major story regarding the study used by Obama to justify Obamacare. The study was completely misinterpreted by Obama and his crack team. It did nothing to speak to quality and the changes in payments by Medicare were a problem with Medicare and not hospital care. It only shows the disparity of pay by Medicare. The Dartmouth Atlas showed costs but only gross costs and not whether those costs prolonged or saved lives. Dr. Berwick called the study one of the most important research in the last quarter century. He is up for the head of Medicare and may not make it thru the Senate for bonehead remarks like that. The researchers are attempting to justify their work. They are having a hard time doing so.
The Obama administration has sent a letter to the PRIVATE Medicare Advantage programs to focus on quality and and price rather than just making seniors pay more for the plan. Most plans will rightly charge more for the vision, dental and hearing aids. Of course the Obamacare wants its cake and eat it too. They are paying the plans less, rightfully, and want the private plans to accede to their wishes of not charging the patients more or providing less services. The problem with Socialism is it fails when you run out of other people's money.
In the same vein, the medical device manufacturers have now realized that there will be a 2.3% tax on all products. This is an excise tax and is not dependant on profits. This means a potential loss of jobs in the industry. Jobs are secondary to the Dems over the passing of the healthcare bill.
Get ready for seeing much more of Obama reading from his teleprompter over the next few months. He and a non profit organization will be doing an all out blitz to defend the health care bill. This will be done by alot of advertising to help the poor Democrats who voted for the bill. The latest poll was by CBS and it showed under 50% in favor of the bill but over 50% said the law should be given a chance to work (Wall Street Journal).
The states aren't so sure. Congress has cut the amount of money the states were counting on for their Medicaid program. With this cut the states will be cutting huge amount of personnel making the job situation even more untenable for the Dems in this election year. Pennsylvania will be laying off about 20,000 people. New York has passed a huge cut in health care spending. These cuts means less money from the Feds. Why is New York doing this? It is because the Democratic controlled legislature will not cut other projects. The State also passed a separate bill to require state approval before insurers could raise their rates. Why? This means no approval and more people on the insured rolls and less on the state rolls. It has nothing to do with need of the private insurers.
The Washington Post has a story of the continuing retirement of physicians and nurses and what this will mean to the healthcare system. About 40% of the physicians are 55 or older and will be retiring soon. Almost 1/3 of the nurses are 50 or older and over half will retire in the next ten years. That's OK since more nurses will be manufactured. Wrong! The studies show that 13% change jobs after one year and 37% were ready to change jobs. The turnover rate is about 13% per year. Access will be a huge problem.
Obama has awarded $23 million for studies on new methods for med mal. They include three year demo projects such as making OB more uniform, offering immediate compensation for medical errors and judge directed negotiations.
In the People's Republic of Massachusetts the insurers are again asking for double digit raises. Since they lost money in the first quarter and are projecting losses for the remainder of the year they eventually will get their increases.
The Republic also is attempting to stunt medical growth by not allowing the building of more medical offices nor the purchase of high tech equipment. They believe that competition raises prices. The Republic is one of the few states that continues to have a CON requirement that has been shown to be price raising in most other states. After saying the above, I can almost understand it in the Republic where the major hospitals run their own HMOs and control all care and prices.
In a poll of 500 people by Mass Insight, it was found that the vast majority of people (over 80%) do not want to be limited to certain physicians or to have treatment decisions second guessed. This may be a problem for the Republic's legislature. In another question as to who the public trusts to fix the health care system in the Republic, the run away victor was none of the above.
Medicare spends more money for prescriptions in Manhattan, New York, than anywhere else in the country. It is 60% more there than in the cheapest place Hudson, Florida. Dartmouth Atlas of Healthcare states that physicians in high cost areas prescribe more drugs and more expensive drugs. This is a per patient ratio and has no relation to how much each drug costs nor what Medicare spends on medical healthcare to physicians or hospitals. In other words, it is an aberration and is meaningless.
Northern Ireland is still confusing treatment with cost. Although cost is never mentioned, it is always there. They state that men should go to their GP who the government control to get information as to whether or not to get a PSA. They contend that the treatments lead to incontinence and impotence. What they don't state is that those that have radical prostectectomy via a robot the complication rate is so low as to almost negligible. Of course they don't have robots is Northern Ireland except those doing the studies.
Ontario, Canada, is cutting out moneys that they pay the pharmacies for generic drugs. They are giving some back in dispensing fees but not enough. Watch for pharmacy closures in the next year in the Province. Top
The MGMA reports that hospitals are successfully hiring physicians, both new and established. They are flocking to hospitals for financial security and are willing to give up their independence. The hospitals are paying more for physicians than the competing established practices. This is especially true for primary care and specialists are seeing a decline in salary.
Medscape reports a study by the AMA that more physicians are seeing fewer Medicare patients due to the low pay and the threat of the major cut in pay. The AMA in a study of 9000 physician found that 17% of all and 31% of primary care physicians are limiting the number of Medicare patients they are seeing. If the cuts went through 50% would stop seeing new Medicare patients and another 34% would stop seeing new and existing Medicare patients.
The Association of Medical Colleges is warning that the new healthcare bill will mean a shortage of about 125,000 physicians by 2025. This means less access, higher costs, shorter visits and generally poor interaction between physician and patient. Look for non physicians to provide health care to large segment of the population with the expected decrease in quality in the future.
The USA Today has a story regarding physicians tacking on fees for non covered things that they do for patients. These include no-show fees and fees to fill out patient requested forms. Some are charging annual fees to do prescription refills and other time consuming chores that are not reimbursed by the insurance companies.
The American Board of Internal Medicine is suing 140 physicians that they say cheated to become board certified. They accuse the physicians of repeating the test questions to others which is an ethical violation. The physicians took a Board prep class from Arora Board Review who encouraged them to give questions to them after they took the exam. The ABIM had to remove or change hundreds of questions due to Arora. 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