December 15, 2012 Recent News





Walmart has started early to tell it's personnel that they will no longer get health insurance through the company but will be put on the exchanges or Medicaid after Obamacare goes into effect in 2014.  The company is following the lead of other companies that will push hours to under 30 per week if they have 50 or more employees.  

Obamacare is the law of the land but not in the hearts of almost half of the population of the country.  Obama has to continue either thru his puppet Sebilius or himself to sell the elephant.  He can follow the lead of the People's Republic of Massachusetts who had the same problem when they passed their healthcare reform.  They did a prolonged blitz of advertising to gain some modicum of support.  The Obama administration has already hired the same PR firm to push the elephant.  The other problem is money.  In the Republic the hospitals, pharmacies and and insurers monetarily backed the law.  That is not happening with the national law.  

The CEO of Aetna has predicted that Obamacare will cause the doubling of some healthcare premiums.  I am sure he knows more about premiums that any government official who can only shake sabers and use doublespeak.  The doubling will be for small business and individuals who do not qualify for government help.  

As if on cue, Blue Shield of California has plans to raise premiums of up to 20% for about 300,000 individuals.  It should be noted that the company has a huge reserve of well over $3 Billion that they say will be needed for the Obamacare changes.  California, like the feds, has no ability to force the insurers to lower their rates that the insurer deems reasonable.

The Washington Post states that Obamacare could reduce treatment options for the 11 million illegal immigrants.  How could this be true?  They were not allowed to be on any federal program before Obamacare and will still not be allowed on any federal program.  They are illegal.  Some states have allowed illegals to be on Medicaid but that was a state decision since they paid most of the bill.  With Obamacare that will not be possible.

Governor Jindal of Louisiana wrote President Obama to set up a meeting with some Republican governors to discuss HHS' decision to not allow partial Medicaid enrollment.  He never received the courtesy of an answer to his letter.  He has again asked for the meeting and now awaits an answer to his second attempt to get a meeting.  Hopefully Obama will be more courteous this time.

In what will defeat Obamacare the states have had only until December 14 to say that they will comply and set up exchanges.  As of the deadline there are only 18 states plus the DC who have responded positively.  The feds are completely unprepared to handle the exchanges.        Top


In the last Medicalaw Update I told about HMA having problems with the fed and their physicians.  CBS' Sixty Minutes had an expose of the hospital's pressuring of it's physicians to admit patients regardless of medical need.  Former employees talked about how they had admission targets and what would happen if they did not  meet those numbers.  The company stated that the story had it wrong and intimated that the 100 or so former employees all made it up.  The Feds are investigating the for profit hospital chain.

Some hospitals in North Carolina are telling their employees that they can either get flu shots or be fired.  If there are health or religious reasons for not taking the shot those people are not considered non-compliant.

To date five people have died from Legionnaires' Disease at the Oakland, Pennsylvania, the water system was contaminated.  This is still present.  Several physicians found the cause several years ago and then were removed from the hospital.  As is typical of the VA and some other hospitals the mantra is deny, deny, deny.

Prime Healthcare continues its buying spree.  Since it has had a problem in California with the unions it has now purchased it's second hospital in New Jersey.  It's latest acquisition is St. Michaels's Medical Center in Newark.  The purchase is from Catholic Health East.        Top


With all the hullabaloo about Obamacare and the lack of primary care physicians along with the temporary increase in payments to the primary care physicians who take Medicaid, one would think there would be many in medical school who would opt for primary care.  That is not the case.  Only between 20 and 25% are going into primary care.  The rest understand the temporary nature of the Obama fix and what will happen to their fees later.  They also understand they will be hit the hardest if the SGR is not fixed.  If the numbers are correct the country will be short about 52,000 primary physicians by 2025.

The physicians of the country are moving toward EMR but not without kicking and screaming.  They are also slowly moving toward meaningful use.  

Two of the largest insurers in Colorado are not paying for patients to see independent nurse practitioners in urban areas.  The nurses say that they are being discriminated against due to physician protectionism.  They can see nurse practitioners in clinics.  The insurers believe that it is their duty to allow the consumers to see the best qualified physicians, not nurses in urban areas.  In rural areas where physicians are scarce the companies allow patients to see nurse practitioners.  

No worries mate.  If you get to see the patients and they are insured with United Healthcare you will only get a pittance anyway.  They will be paying for pay for performance, whatever that means.  All that is known is that it will be less from the insurer to the physicians and usually more paper work for the physicians.

In an interesting tidbit, the MGMA has found that physician owned multispecialty groups had operating costs of about $528,000 per FTE physician.  This was increased about 1.2% last year.  In hospital owned groups the operating cost was only about $380,000 per FTE physician but the increase last year was over 6%.      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.