April 1, 2011 Recent News

Licensure

Insurance

Healthcare

Physicians

Licensure

Public Citizen is after more publicity.  At least once a year this "organization" blasts medical boards for not disciplining enough physicians for whatever reasons they can think of.  There is little thought process given to their analysis.  This year they say that 53% of physicians disciplined in some way by a hospital or had malpractice payments were not disciplined by the medical board.  These are gross numbers by taken the total number of physicians in the NPDB over a period of years and dividing by the number of those physicians disciplined by the Boards.  Total nonsense numbers.  They do not take into consideration the ease of hospital actions and the "sham" actions and the more difficult burdens of proof required to take away a license.  I wonder if they ever wonder why no one listens to them?        Top

Insurance

California Blue Shield has cancelled its announced premium increases for individual members.  The publicity did them in.  It was going to be up to a 87% increase for some subscribers in the past year.  Blue Shield also said there would be no increases for the remainder of the year. California can not stop any health insurer from raising rates.

California Blue Cross has followed suit and delayed as well as reduced a rate increase.  The increase will go from 16% to 9% and will be delayed until July 1.  Those members with basic hospital plans will see a decrease in rates.  A PPO policyholder sued since his $1500 deductible went to $1750 in the middle of the year, a breach of contract.

There are now approximately 52 million people in America without health insurance.  This reflects on the economy and the loss of jobs.  This study was done by a left leaning organization who stated that Obamacare will take care of all these people under Medicaid which can not be funded.  Obamacare will make healthcare more expensive by adding multiple mandates to insurance.

In the entire country only 13,000 people have signed up for the very expensive no pre-existing condition insurance.  People must also be citizens or legal immigrants as well as having no insurance for the preceding six months to qualify for the insurance.  Again, Obamacare will not do anything to reduce premiums. 

The Blues of the People's Republic of Massachusetts have stated that expanding health insurance coverage without cost controls is unsustainable.  Costs include administrative cost reductions.

The cardiologists are pulling support for Connecticut's SustiNet health plan after the state's lawmakers pulled a malpractice liability provision from the bill.  Four other specialist groups are also likely to pull their support as well. This would lead to few physicians taking the patients.  Lawmakers removed a provision that would protect physicians treating plan patients from liability if they injure a patient covered by the plan while following clinical car guidelines.  With the protection pulled they state defensive medicine will prevail and expenses rise dramatically.  The legislature is doubtful regarding the bills passing.     Top

Healthcare

You know you are in trouble when the showcase of your career needs help one year after it is enacted.  That is what is happening to Obamacare.  The Dems have been given their marching order.  They are to go back to their districts and get support for the program that most of the country and most of the states want repealed or at least modified to a great extent.  

How much is Obamacare going to cost the taxpayers just for Medicaid?  Between 2014 and 2016, the feds (us) will pick up 100% of the medical costs of all enrolled in those two years.  After that the fed portion gradually drops to 90% by 2020.  For those enrolled prior to 2014 the percentage will remain as now, 62% of the cost is borne by the feds and the remainder by the states (us also).  This should raise the deficits of both the states and the feds significantly.  

Medicaid enrollment is now increasing quickly because of the economy and lack of jobs.  It is expected, according to the nonpartisan Center for Studying Healthcare Change, that those areas with the largest increases in Medicaid will have the least amount of primary care physicians willing to take them on as patients.  This includes the increase in pay to those physicians. 

Georgia has said that the law putting children up to age 26 on their parent's health plan will cost the state in 2011 alone almost $18 million dollars.  In 2014 when the Medicaid fiasco hits the state will pay an additional $2.4 billion over the following ten years.  Money it doesn't have.  

The government got it wrong again.  This time they under estimated the out of pocket expenses Americans paid for healthcare in 2009.  They missed by 14.7%.  Most of that was on supervisory care for loved ones by friends and family.  Most spending was done by non-Medicare patients and those with incomes under $100,000.   

An article by AAPS states that a big business hospital culture may be fostering physician mediocrity and sham peer review against those who care about the care the patients receive.  

A new study by RAND, the largest ever, has found that people with skin in the game via high deductible health plans spend much less on health care.  The problem is they also are cutting back on necessary preventative care.  

In 23 states nurse practitioners can work without a physician supervisor.  California is one of those states.  In areas where access is very poor such as Los Angeles and San Francisco, the city hospitals are using them as the primary care provider for "medical homes."  The turf war is that the physicians believe that since the nurses do not have the breadth of training that the physician does, they order more tests and use more referrals.       Top

Physicians

Merritt Hawkins has released 20 statistics on guaranteed income or base salary offered to recruited physicians.  They range from a low of $175,000 for General Practice to a high of $519,000 for Orthopedic Surgeons.  The majority of the cognitive are under $250,000 and the majority of the surgical specialists are being offered $300,000 to $500,000.

The March 29, 2011, Wall Street Journal has gotten into the Medicare records and found a neurosurgeon in Portland, Oregon, who operates on people's back multiple times for fusions.  He is at the top of the Medicare list.  His call group has just removed him.  His name is Vishal James Makker.

Physicians in pain management will not be able to get payment for putting in EMRs.  The reason is the lack of ability to do prescribing for narcotics on line in any state and the intrusive regs that are required.

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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.