November 1, 2010 Recent News
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Kaiser Health News reports that hospitals continue to lure physicians from private practice to become hospital serfs. Last year half of the new physicians that went into practice joined hospital staffs as employees. The reasons are both the economy with fewer patients and the new physicians not wanting to take control of their professional lives. They do not want to work hard and want the time off for family life. With more physicians joining hospitals and the new ACOs coming into play, look for prices paid by insurance companies to rise.
The New York Times has an article regarding the continuation and slight increase in surgical errors in spite of the JC's proclamation. Between 2002 and 2008 27,000 incidents among 6000 physicians were reported. There were 25 operations on wrong patients including three prostatectomies.
The LA Times reports that consumers should pretty much ignore the government's Hospital Compare website. The ACS states that there is no difference between the lower and higher performing hospitals on the site. The ACS wonders if it is worth the hospital's time and money to continue tracking and reporting this "safety" information.
HealthLeaders report on how hospitals are proving payor preauthorizations. A Florida hospital kept getting preauthorizations to perform procedures and then the insurer would deny it saying they never received the preauthorization. Some of these were phone conversations. The hospital hired a company that tracks calls and faxes and the insurers could not play their games anymore.
In an unusual turnaround, Anaheim Hospital in California has now been approved for Medicare payments. they lost their accreditation last year. The hospital stayed in business with an active ED and a daily census of five to ten patients a day. The CEO is attempting to rebuild trust within the community.
The USA Today has a story about the race for physician hospitals to beat the clock to get all in place so they can receive Medicare funding after January 1. They must be certified by the start of the new year. There are some hospitals that will not make it and will have to be sold to non MD individuals or hospitals. It is the hospital association that was afraid of true competition that pushed this into the law. Top
Boeing is cutting back on its health plans and states it is due to Obamacare. The company is informing its 90,000 non union workers that they will be paying more for their healthcare. They state the new "free" healthcare requirements and the tax on "Cadillac" health plans. Boeing plans fall into that category and they do not want to be taxed. Boeing is raising deductibles and instituting co-pays to lower the value of the plans in order to avoid the tax.
The Bloomberg News reports the Obama administration is catching on to the problems with the Obamacare mandates. There will probably be many employers who will be allowed to switch insurers without the onerous penalties that come with switching under Obamacare. If they have to play be the rules, more layoffs will be forthcoming.
Many, if not most, employers are willing to pay the copays for their employee's preventative care. It is much cheaper to pay the average $20 copay than to spend money down the line for people with preventable diseases.
The Washington Post reports that Obamacare does not do anything to reduce the cost people pay for healthcare. They state that universal health with one payor is the way to go. The paper states that Obamacare focused on holding down procedures and patient interfaces and not costs per encounter. The paper states the politicians did not want the wrath of the hospitals and physicians. The politicians decided that integrated care was best to hold down visits ala The Mayo Clinic. They then went on to name this value. Of course, Americans already have fewer visits and shorter hospital stays than those in other countries. This takes technology and technology costs money. The Socialist writer does not address this.
Kaiser Health News has a fascinating story about the pilot programs underway across the country to increase quality and decrease costs. This has been ongoing for the past 5 years. Interestingly, the studies have shown a slight increase in quality as measured by some preventative measures but no decrease in costs. This may put the financial kibosh on future pilot projects.
The USA Today has an article about the problems Democrats face with the senior voters. They are very concerned about the lack of work on the SGR and the $500 million cut in Medicare spending. The seniors are reading alot about lack of access for them under the new plan.
The Republicans have stated that a goal after the midterm elections will be to get rid of the SGR. The problem will be to find some way to get $300 Billion to $400 Billion to cover the gap. Of course logic is that the financial gap does not need to be covered since the SGR was never allowed to take place. It was an exercise in accounting only.
The Miami Herald has a story about how costs for individuals working for the state or a hospital with insurance will pay more for all aspects of care. They state the increase will range between 8% and 12% on premiums and more on co-pays. The increase in the co-pays and the premiums mean the people still have jobs.
CNN MONEY reports that many insurers will either go out of business or drop health care insurance by January 1. This is to avoid the increased percentage of money devoted to actual care. The feds have asked the National Assoc. of Insurance Commissioners when the rule should go into effect so as to be the most agreeable with the insurers. The insurers have asked the organization to transition the rule. The large insurers may be able to meet the rule but the smaller ones will not.
The California HealthLine reports that high deductible health plans keep people from getting care. It also says the people were not smart enough to get Health Savings Accounts.
The Orlando Sentinel reports that the benefits of employer health plans will not change much in the coming year however, the costs of the plans (premiums, deductibles and copays) will increase. They believe the major increases will be in 2014 when Obamacare comes into being.
NPR reports that all these increases are not from Obamacare. Their information is from the administration and Sebelius. One of the heads of the Insurance industry says it is a combination of health care reform and rises in medical costs. Those who have less comprehensive insurance now will see a large raise when the new mandated benefits come into being. All agree the new law will do nothing to reduce costs and therefore premiums.
The Wall Street Journal reports that whereever there are very close races for Congress or the Senate, healthcare reform is very unpopular.
The Wall Street Journal has an article about the RUC committee of physicians who determine how much of the pie each procedure or visit is worth. In an accompanying article it discussed how little primary care is represented at this committee. The people at CMS are considering doing the pie breaking without the physicians. They have no idea about any work required for any procedure and are only government hacks.
In the People's Republic of Massachusetts the state medical society reported that since they put in their universal health over half of the primary care physicians are not accepting new patients. This is leading to a major access problem. To make matters worse the specialists have become harder to find as they are leaving the Republic and do not want to be hired by the hospitals.
MarketWatch has reported on the access problem in Canada. Canada is one of the only developed countries that do not have any private insurance. They do allow people to pay out of pocket for some things such as MRI if they do not want to wait several months for the test. The Canadians love their care and do not want it changed. However there is beginning privatization in some provinces. The provinces are being strapped for money as there are more elderly and more care needed. Ontario now spend over 50% of its revenue on health care. The president of the Canadian Medical Society agrees that there are significant wait times and some die waiting whereas many others have significant pain and suffering waiting for treatment. Hospitals are also in trouble since they are full. Patients spend up to days in the ED waiting for a bed. The hospitals also push for early, maybe too early, release of patients to free up beds. The Canadians know of the problems and are still happy and are willing to pay more taxes to keep their universal system. Top
A Chinese urologist is under arrest in China for hiring thugs to attack people who were critical of him and a new procedure he developed for congenital incontinence. He had taken his treatment to the US and several hospitals and physicians have tried it on their patients. He has gotten 30 letters of support from Canadian and American physicians since his arrest a month ago. He has been sentenced to 5 1/2 years in prison.
A Bridgeport, Connecticut, newspaper has an article regarding two physicians and their response to Medicare reimbursement or lack thereof. One is a primary care provider who practices out of his home and the other is an ophthalmologist in a standard office. The primary care provider formally dropped out of Medicare. He could no longer stand the uncertainty of the reimbursement and the potential for inspections because he takes longer with his patients and bills accordingly. The ophthalmologist can not withdraw since 80% of his practice is Medicare. If he withdraws he would have to close and if he continues with Medicare not paying much he will not be able to continue for long.
The AMA has an article on the "physician payment reform" that is supposed to increase quality but in reality only drives down payments. The insurers state that pay for performance will increase quality but they have no idea what quality is as all they see are bills with codes. They believe erroneously that bringing back capitation will do the job. All it did was delay everything, reduce pay and make the physicians, hospitals and patients angry.
Then there are the "progressive" physicians of the People's Republic of Massachusetts, mostly on salary. 34% are for universal healthcare but an equal number are for private healthcare with Medicare type buyins. Only 14% are for the currant People's Republic model of health care. Top
Two Pennsylvania insurers, Keystone Mercy Health Plan and AmeriHealth Mercy Health Plan lost a portable computer drive have refused to apologize for accessing members health information at community health fairs. They say they needed the information but it was on a flash drive that was lost. They compromised the health information of 285,691 Medicaid patients. The information was not encrypted. The Medicaid patients will receive special scrutiny of their financial and medical information.
A high profile person in Dayton Ohio Miami Valley Hospital had his medical record looked at hundreds of times. The hospital has no way to know how many were legitimate and how many were looky-loos. The article goes on to state the problem with privacy with EMR and someone attempts feebly to say that paper records are as prone to privacy problems as EMR. 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.