September 1, 2010 Recent News

Insurance

Healthcare

Hospitals

Physicians

Electronics

Insurance

Seventy per cent of large employers will get rid of lifetime caps for health insurance.  At the same time 63% have decided to raise premiums for 2011.  This include an increase in network deductibles and out of pocket costs.  About 5% are dropping coverage for retirees and and additional 60 percent are considering it.  This is due to the feds closing the doughnut hole for Part D Medicare.  

States are making teachers and other public employees start to pay for something for their healthcare.  This include retirees.  Some teachers believe they shouldn't pay anything as their colleagues in private sector are.  They are suing Michigan and New Jersey so they won't have to pay up to 3% of their premiums.  It is interesting that both states are run by Democrats.   

After all the stink about Blue Cross raising rates and after all the investigations by California, Blue Cross is raising their rates almost the same amount as before.  The rates are going up 14% to 20% instead of 39% for individual policyholders.  They plan on major rate hikes again next year.     Top

Healthcare

Obamacare has failed to help the people feel more secure about their own medical care.  This was reported by the AP.  This may be because the plan does not start until 2014 and people only look at the here and now.  Those with the highest confidence were seniors on Medicare and those with the lowest were low income and those in poor health.    

Kaiser Health Tracking has found that Obamacare is at it's lowest approval ever.  Support of the plan was at 43% and opposition rose 10% to 45%.  The individual mandate had a 70% disapproval rating.  This led directly to the following story.

Obama and his cronies are back.  More people are against Obamacare and so expect more exposure to Obama and his cast of characters.  The first was Sebilius and her tout of the one million $250 checks that have gone to Medicare Part D beneficiaries.  Pelosi then chimed in to make sure those who received the huge amount of money know it was the Democrats in Congress that did it.  Somehow, they all forgot it was the Republicans who passed Part D in the first place.  Yes, there was and is a doughnut hole.  That was placed for several reasons.  The first was to push people to have some say in what meds they were getting.  Generics are cheaper.  Also, the government can not continue to just pay out money there must be some patient contribution.    

Obama is also pushing hard.  He knows physicians are stopping taking Medicare patients and he needs the physicians to back his plan which they don't.  He showed his true colors by now having DeParle stating the physicians will get money for electronic records but only if they are good and cooperate. She never defined what was meant be cooperating. 

In the same article DeParle writes that small practices should join hospitals or larger practices.  She does not believe that individuals should be able to set up shop.  It sounds more Socialistic with each word.  She wants vertical integration with one organization owing the hospitals and physicians.      Top

Hospitals

The Los Angeles Board of Stupes, who screwed up the Drew/King hospital several years ago and who now run other hospitals in the county are trying to stop the hemorrhage of med mal claims.  They ordered their hospitals and clinics to improve patient safety.  The Stupes were pushing for access to peer review records to hold physicians accountable.  They will not get them since state law holds them confidential and the Stupes want the information on a Web site.  They have never realized that they are the biggest problem. 

Bloomberg wrote a scathing report on the predatory practices of Sutter Hospitals and Foundation in Northern California.  They get huge payments compared to outpatient facilities and other hospitals due to control of most of the facilities in the area.  The article spoke also about Inova in northern Virginia and Dartmouth in Vermont.  They see this becoming even worse with Obamacare and ACOs since there will be even more power concentrated into fewer hands.  

What's the difference?  Monopolies or ACOs?  The Boston globe discusses Carillon Clinic in Virginia. Two hospital in the town went together after fighting off a federal antitrust probe.  They then switched to a clinic setup and purchased over 200 physicians.  They are in a prime position to garner the money the feds are offering for ACOs.  They have a new $100 million EMR system.  There is no one in the area that can compete with them.  They can command and receive high prices from insurance companies but at the same time can cut costs by doing the things that are necessary to keep people out of the hospital.  So are they a monopoly?  Yes.  Are they a future ACO?  Yes.                 Top

Physicians

The AMA has dodged a bullet.  They now only have 16% of the nations physicians in their fold and almost lost many of those.  The Florida Medical Assn. voted to stay with the AMA but sent them a letter of censure over their actions on health care reform.  It is a vote of no confidence in the organization.  

The Annals of Intern Medicine has shown that those physicians that apologize for mistakes have fewer law suits and pay out less in settlement.  The article came from the University of Michigan and not only showed the above but also a shorter time to payment and without any courts and less money for attorneys.  All a good thing but they state that more studies are needed. 

More physician have stopped taking Medicare patients.  According to Cigna Government Services physician are not only dropping out of the program entirely but even more are quitting taking new Medicare patients.  As Medicare continues to ratchet the prices paid and the overhead increases more will drop from the rolls.  The exception will be those physicians owned by hospitals and paid on salary.  

California has found that very few physicians are taking Medicaid patients.  A recent study showed about 90% of California primary care physicians are taking new patients.  That falls to 75% for Medicare and drops to 57% for Medicaid.  The wonks were asked what to do and they came up with the usual suspects of medical home and train more physicians.  They don't say that physicians don't want to become primary care physicians because they have loans to pay off and families to support.  They don't say to decrease the red tape and pay more money.  They are not practicing physicians.

Illinois had taken all physician records off line except those related to state discipline.  Orginally they had placed hospital actions, past criminal convictions or forced medical malpractice payments on line.  They found they were not capable of either checking what they put on line was accurate nor able to keep up with the information.  The information was placed on line as a compromise to get med mal reform.  The proviso was if the reform was overturned then the information would be removed.  The Illinois Supreme Court tossed the reform so the information went as well.

It is hard to believe but two physicians got into a fight in Italy just before a patient was to have a C-Section.  This delays the section for a little while.  The baby was born with a heart defect which had no relationship to the fight and the mother had no complications.  The Italian health minister apologized to the mother.  Can you imagine Sebilius doing this when all is socialized?   Top

Electronics

After these several years of the government shoving electronics down the throat of physicians and hospitals, Modern Healthcare reports that under 2% of hospitals are ready to meet EHR standards.  Over 10% of the hospitals have the EHRs but the programs are not ready for "meaningful use".        Top

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  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.