December 1, 2015 Recent News





Today is the last day to enroll in the world's most expensive medical insurance if you want coverage to start on January 1.  Those who try today and fail due to not enough telephone lines will be allowed some extra time to lose their money.

The fed is now spending $3 TRILLION or $9,523 per person on healthcare.  The huge expansion under Obamacare plus the rising costs of drugs are the reason.  This is about 17% of the economy and is much more than other developed countries pay.  Since Obamacare came to life there has been an increase of 7.7 million people in Medicaid.  Drug costs have increased by 12.2% last year up from 2.4% the year prior.  Physician and hospital services climbed a massive 4% last year.  This means that the delivery of services was not the cause of the huge increase.  It was all on the Obamacare and drugs.

Kaiser Health News reports that Obamacare plans offering PPOs are screwing the public again.  They have removed for the coming year the caps on how much a patient will pay for out of network care.  About 30% of silver-level plans will have no caps.  This is difficult to find on most insurance websites.  The insurers are doing this to help keep premiums down.  They have increased liability due to Obamacare's requirement of no pre existing conditions and no age ratings.

Obamacare could be very bad for the economy says the CBO.  It may reduce the workforce by about two million people over the next decade.  This 1% decrease in the workforce is due to people choosing to work fewer hours or leave the workforce completely in order to receive subsidies for their health insurance.  The Obamaites are spinning it to say it gives the workers more flexibility; to go on the dole.

The administration for the first time is not having any extra enrollment time for the Obamacare high cost insurance.  It signup will end on 1/31/16.  If you are smart enough not to enroll then you will have to pay a penalty of $325.  This is small potatoes compared what you will pay for a premium or co-pays for this insurance.

Last month United Health said it was losing money on Obamacare and may not continue in the program.  Now they have said they will not pay insurance brokers commissions on sales of individual health plans.

Cigna has also said it is losing money on Obamacare but will remain in the program for now.

Obama is an ass.  He is going against not only the GOP but this time his own party to keep his signature health measure intact at the expense of the economy.  Both parties want and are planning to add to the budget either a delay or repeal of the Cadillac tax under Obamacare.  He has threatened to strongly oppose but not veto the measure.  

The San Francisco Business Times reports that Kaiser Permanente is acquiring Group Health Cooperative in Seattle with about 600,000 enrollees.  This will be a new region for the organization.  Kaiser is spending $1.8 billion to endow a community foundation in Seattle as part of the deal.  Group Health is a non profit.

The NYT has a story on how survival rates for CPR can differ from city to city.  Seattle is the best at about 20% a survival rate.  In Detroit it is 3%.  This is directly related to training the citizens in bystander CPR.  Experts now recommend that CPR last about 45 minutes before call it quits. 

Boston Scientific has recalled their Chariot guiding Sheath due to pieces coming off in patients.   

In Great Britain the physicians were to go on strike.  This was cancelled at the last hour due to the government agreeing to another round of talks about the hours and pay of the junior physicians.  This will come back if there is not a movement by the government. 

Still in GB the NHS is to begin charging foreign tourists to any care in the country.  The only free service will be a visit to a GP.         Top


In a major study, it was found that 55% of the country's physicians have "burnout".  This is a 10% increase in the past three years.  This poses a danger and a problem for patients.  It was recommended that those in this field look at the drivers of this and attempt to correct them not just focus on self help for the physician.  

The Chicago Tribune also had a story on physician burnout.  This one focused on the EHR as a driver.  It told the story of an internist who had to cut back one patient per hour in order to do her EHR.  She did not think it was helping patient care by checking boxes and sending in a report.  She was correct.  The story goes on to tell of physicians later in their career folding up their tents instead of practicing for another year or two.  This is directly related to the EHR.  The AMA reports that half of the physicians in practice are emotionally exhausted due to heavier workloads and increased clerical responsibilities.  There is good evidence the EHR is helping patients get more access to their records and medical information as well as the promise of collecting information on populations.  At what expense. Physicians continue to delight in the ability to bring up records at home if a patient calls after hours but hate the federal mandates and software crashes as well as the lack of interoperability.  The AMA states that the amount of physicians that are attesting to meaningful use is decreasing not increasing.  About 250,000 physicians will be penalized this year for not having "meaningful use".  

Infectious disease residency (fellowship) programs only filled about 60% of the slots.  This has been an ongoing problem for the sub-specialty.  They make less money than hospitalists and take longer to train.

If it wasn't bad enough having hospitals and insurers buy physicians now the staffing companies are doing it.  Hospital based physicians such as ED, radiologists, hospitalists and anesthesiologists are being consolidated.  This is a trend that has started.  Physicians are not interested anymore in running their own practices and remaining independent.  They are selling out for salaries and upfront monies. They are also being pushed into this by the feds and insurers bundling and other financial gambits.  Also the getting of new contracts means a three month wait for payments to start to roll in.  Too long to wait.  Better to have a sugar daddy wait and be paid.  An interesting business is to purchase a percentage of the revenue stream and leave the physicians independent. 

Cuba has imposed a travel permit requirement on physicians and nurses.  This is to stop a "brain drain" to the US.  This is the first back step by Castro since announcing the unrestricted travel in 2013.  Some of the Cuban physicians are now considering quitting medical practice so they can to travel.  Physicians now earn about $80 per month.  The US is blamed for continuing to allow all Cubans to have automatic citizenship.        Top  


California's AG has given a preliminary OK to the purchase of Daughters of Charity hospitals by BlueMountain Capitol.  There are contingencies such as remaining a nonprofit and preserving the jobs and wages of the employees for 10 years.  BlueMountain only wanted five years.  This is the same term as was offered to and declined by Prime.

Soon after the above appeared it was announced that BlueMountain has agreed to the AG terms. The new system will be know as Verity.

Mercy Medical Center in Redding, California, is back in the news for the same thing, failure to allow tubal ligations at the hospital.  The Catholic hospital does not allow abortions or tubals.  This runs counter to California law which does not permit hospitals who receive public funds to deny medically indicated pregnancy care.  The question is whether or not tubals are medically indicated or for the mother's peace of mind.  It is being sued for not allowing two women to have tubals post C-Section.  It is being recommended for the women by the same physician for questionable medical reasons.  I wonder how long the physician will remain on the staff.

Brigham and Women's Hospital has its first budget short in 15 years.  Why??  Epic.  There were the usual overruns not budgeted for.  In this case it was $27 million more than originally budgeted.  This has cost 20 people their jobs and keep an additional 80 from being hired.   

Cerner Health does like being the target of its employees suing it for their screwing up on payments.  It has given its Kansas City hospital employees a choice.  They can give up their right to sue the organization and receive merit pay increases or continue to be able to sue and only get raises when promoted.  It remains undecided whether this is legal or not.  Watch for a NLRB action.        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.