August 15, 2014 Recent News






CMS says the Part D premiums will only go up $1 per month for next year.  Tavenner lied again when she stated the small increase was due to Obamacare.  Obamacare does not deal with Medicare at all.

The IBD has an oped regarding the Affordable Care Act that Isn't.  It talks about the huge increase in premiums in California for the 2014 year.  They increased premiums between 22% and 88%.  There is not a problem with the huge increases as long as you don't have to pay them.  Remember in Mrs. Robinson the word was "plastics". Now the word is "subsidies".  Then there is the risk corridor where insurance companies get bailouts for going with Obamacare at the cost to the taxpayers.  Anyone know about this?  Of course, there is also the $63 "tax" to all who sign up for Obamacare to pay for a three year re-insurance of $20 Billion to cover high cost insurees. Lastly is the recent revelation by the GAO that has cost almost $1 Billion so far and the end is not in sight.  There is also the almost $5 Billion spent for the state exchanges.  As Ev Dirkson once said " One Billion here, One Billion there and pretty soon you are talking about real money".  There is also the recent study that showed a significant increase in the number of people who are working 29.5 hours and a decrease in those who are working 30.5 hours.  Remember those working over 30 hours a week get covered under Obamacare.  This has cost these low paid workers money.  

The Boston Globe in mid July had a major front page story of the horrors of Electronic Medical Records and how terrible it is that the feds do not mandatory reporting for medical errors caused by the systems.  I reported on this story in the last edition of  In response to the Boston Globe piece the Obama mouthpiece Karen DeSalvo sent a letter to the paper attempting but failing to blunt the article.  She stated that the article did not show any good done by the EHR.  She then went on mouth the administration pap that voluntary reporting was as good as mandatory reporting.  Rubbish.

It appears the "tax" of Obamacare will effect almost no one.  There are so many exemptions for the tax that the WSJ estimates 4 million of the 30 million without insurance will pay the "tax".  Obama gave those whose plans were cancelled a two year (until after the next election) moratorium on paying the "tax".

HHS researchers have found that Medicare Advantage plans routinely over bill by overstating how sick they are and the cost of care.  This is usually called fraud.  From 2008 to 2013 the plans were overpaid about $70 Billion.  They upcode diabetes complications and have a huge amount of drug and alcohol problems, much more than fee for service Medicare.  In any other setting this would be fraud fraud fraud.

The average Obamacare premium increase in the country will be about 7.8%. The average monthly premium will be $384.  Nevada will raise premiums about 38% and Arizona will decrease some premiums 23%.  Florida's largest health insurer, Blue Cross and Blue Shield, will raise premiums an average of 17.6 percent in 2015.  They lost oodles of money with Obamacare in 2014 and do not want a repeat performance. This is compared to the national average of 8% for next year for a 40 year old non smoker in the silver plan.  The range is from the low of 1.4% in Oregon to 16% in Indiana.  California just announced a 4.2% increase.  The Florida CEO says the reason for the increase is the scarcity of young healthy individuals and more appetite for expensive treatment. 

Politico states that the large premium increases are in states where the patients with Obamacare could change back to their original insurances.  Many, especially the young, did that which left the older sicker people in the exchanges.  

It seems that those that originally signed up for Obamacare are having second thoughts.  Aetna reports that of the original 720,000 that had enrolled in May the number by the end of the year is expected to drop to about 500,000.

Also CMS has sent out notices to 310,000 people who signed up for Obamacare to prove they are legal immigrants or have their subsidies removed.  

California is paying 95% of the state employees health costs in 2013.  Nationally, 92% of state employees get their health care costs paid by the state.  Many of the employees have no deductible plans.  When one has no skin in the game they have no reason to look at their spending.

The VA is making good.  They have now sent over 800,000 vets for care with private physicians, a 25% increase over last year.  Each referral has resulted in about 7 visits.  There are problems with recruitment as many physicians are leery about a place with the work record of the VA.

We all know the French are nuts but now we have proof.  The law in France regarding end of life says that there is no euthanasia but allows physicians with consult with the family to end a life to relieve suffering.  The physician acts alone and even though consults with the family does not have to listen to them.  The case of Lambert is an exception to date.  He is in a persistent vegetative state and the physician has removed the feeding tube.  The Catholic parents sued and lost in all French courts but have now appealed to the European Court.  A recent case had a physician tried for causing deaths and the jury declared him innocent.  In France this is being appealed.  The French want to take emotion out of the decision and let a third party, the physician, make the life or death decision.        Top


Lakeland Hospital in Florida has suspended all surgeries due to potential poor sterilization.  They found out their instruments were used in a patient that was later found to have Jacob-Creutzfeldt Disease.  Kudos to them for patient safety over the bottom line.

Hospitals are doing their part in EHR adoption.  About 60% of the hospitals in the country are using the programs.  On the flip side, only 6% of the hospitals have met Stage 2 Meaningful Use.  They have until October to become certified or lose incentives.

Kaiser continues to do well financially.  It had a net surplus of 25% fueled by cutting back its capitol spending and increasing its members.  It had a $1Billion surplus in the quarter on $14 Billion in revenue.  It added almost 400,000 new members in the first six months of the year.  Capitol spending was down just over 20%.

Prime is primed to buy yet another hospital.  New Jersey Planning Board has approved the purchase of Saint Claire's assets including three hospitals.  The State Health Commissioner now has 120 days to make the final decision.        Top


Physicians have leapt to EHR with about a 78% having the systems and about 50% stating they can actually share the data.        Top


The report is that Casey Kasem's body is now in Canada and on its way to Oslo.  This avoids the subpoena to have an autopsy to prove or disprove the wife's culpability in the death of Casey.        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.