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The New York Times is now getting on the bandwagon regarding the high fees charged for out of network patient care. It details the stories of people who either went to out of network institutions or if they went to appropriate institutions were seen by out of network physicians. The insurers complain that many times they get bills that are 30, 40 or nearly 100 times what Medicare pays. What they do not say is that Medicare is not the guideline but is a low paying plan. The insurers base their rates on this low paying plan not on commercial rates usually paid. The insurers have changed reimbursement schedules to shift costs to the patient. This leads to the patient picking up more of the billing. Top
A London based orthopedic reconstruction company with plants in Tennessee and Massachusetts has announced it is letting go 2.3% of its workforce in the United States due to the new Obamacare medical device tax. In late 2012, Stryker, another orthopedic device maker began laying off over 1000 people again due to Obamacare's medical device tax.
Who is the individual mandate going to effect? Almost nobody. CMS has allowed so many exemptions that almost no one will be dinged with the mandate. Those poor souls that are can take solace in that the IRS will not access any penalties or interest if you do not pay. This latter population is only 2% of the people who do not qualify for an exemption.
Sebelius is on the panic bandwagon. In a speech to the National Health Policy Organization she intimated that if the states do not go along with the Medicaid expansion Obamacare will not work.
The White House (Obama) is again resorting to scare tactics to get the country behind overturning his own idea of sequestration. He now states that more medical care will be lost if it goes into effect. The rhetoric will get more as his idea comes closer to fruition.
The People's Republic of Massachusetts is again in the news for it's stupidity. It passed a law that medical costs can not raise faster than the other cost of living in the state. It is. The healthcare commission can then coerce the hospital or physicians to reduce costs. They can not yet on their own reduce rates paid to hospitals and physicians in the state either individually or collectively.
In a story that is over the top in what happens when a hospital attempts to meet healthcare targets, the New York Times reported on Safford Hospital in Shaffordshire in England. The conditions were so appalling that people had to drink water out of their flower pitchers since there was no other water available. The hospital needed to save $16 million dollars to meet criteria for what is known as foundation trust status. In order to do this they laid off too many people to save the money and the patient be damned. The head of the NIH may have to resign and an inspector of hospitals comparable to our JC will be appointed. Top
Cardiologists are fleeing independent practice to the employed world due to CMS. The feds decreased the cardiologist's major money maker, studies, to only about half of what it used to be. This will increase costs since there will be less competition and CMS stupidly pays a lot more for the same studies in hospital outpatient settings than they pay in physician offices.
Unionization is coming. Kaiser Permanente, the for profit physician arm of Kaiser Healthcare, is set to vote via mail by April 29 on which union they want to join. Their choices are between the National Union of Healthcare Workers and SEIU-United Healthcare Workers West. Top
The California Department of Public Health fined seven more hospitals in the state for unsafe medical conditions. One hospital UCSF received three fines.
It pays to be a non profit HMO hospital organization with your own medical staff. The San Francisco business Times reports that Kaiser non-profit arms reported a $2.6 Billion net income or profit in 2012. This included operating revenues, operating income and non-operating income for the year. This does not include the Permanente Medical Group, the for profit physician arm. Membership increased by 131,000 to over nine million. They state they have instituted cost savings so there will not be a need for increased premiums. They did not state what these cost savings were.
St. Joseph Medical Center in New Jersey has been decertified by CMS on December 1 and has been unable to collect any fed money since that time. The hospital had been a hell hole for physician kickbacks under it's prior owner so applied for a new accreditation after the new owner took over. They failed the inspection for unknown reasons. The hospital will not speak about the problem.
Terrell, Texas', only hospital was closed by state regulators as well as CMS. You can imagine the number of problems it had. 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.