February 15, 2008 Legislation





It just gets worser and worser.  The People's Public of Massachusetts is getting deeper and deeper in the hole.  The idiots who passed the state's law to cover all people must be running for cover.  The newest numbers are that it will cost the state up to $1.35 Billion by June 2011.  This is double the original cost.  The state wants the feds to pay half the cost from 2009 to 2011.  This means the taxpayers of the state will be paying twice with state and fed tax and the rest of us will be paying for their folly.  Another source of payments is the money due the hospitals under the original promises made by 
Gov. Rummy.  He blames the high cost on the new Democratic Governor and the Democratic legislature.  However, he signed the changes made by the legislature.  

The Republic is doing a good job in keeping down costs since the projected increase in premium for the next year is only 5%, about half of private insurers.  This is about 16,000 subjects of the Republic.  

In a study of community hospitals in the Republic about 10% of all the prescriptions given to patients were wrong and resulted in harm.  This gives one a warm and cozy feeling.  The public is told not to worry about their hospital because of the study.  They have a right to worry because of other things as well.

The Department of Veterans Affairs is increasing the mileage allotment payable to vets who have to travel for health care.  They have been getting $0.11 cents a mile and will now get $0.285 per mile.  This is the first raise since 1977.  I would think it would be cheaper just to scrap the VA and put the vets into private medicine. 

To make matters worse for the vets, the government is fighting in court the vet's ability to get therapy for mental disorders.  The government argument is that Congress has the exclusive ability to determine who should get healthcare and what type of care.  This is not a judicial case, states the government.  The government goes on to state that he care to be received is limited by the funds available.  The judge has already disallowed the government from being awarded summary judgment.  Yet another argument for getting the system out of the hands of the government and into the private practice arena.

President Bush has sent a budget to Congress that deletes $560 Billion from the Medicare program but does not touch the private insurer program of Medicare HMOs.  This is faulty as all programs should be affected. The funding would potentially decrease to a minor degree payments to physicians and hospitals if certain spending limits are reached.  This would only apply to fee for service and not HMO provider services, a poor distinction.  This was announced on the same day as Humana announced that it had a 57% increase in its fourth quarter profits. Much of the profit was due to the increased Medicare HMO business and the decrease in Medicaid business during the quarter.  Cigna joined the parade with increased membership and increased net profits.  Most of its increased membership was from the purchase of an Indiana company and from ex-pats. Aetna has also had an increase in profits but not to the extent of the others.  The reason is that their payout is up 2% to 80% of collected money.   

In the area of legislative stupidity, Michigan has a law that prohibits not only illegal aliens but also those in the country on student visas or work visa from getting driver licenses. This include physicians here under the J-1, H1-B and other similar visas.  These physicians will not be going to Michigan since they can not get to and from the hospitals. About 1/4 of the residents at the Michigan hospitals are on visas.  The dumb legislators are considering revising the law but to date have not done so.  

New York Attorney General Cuomo is investigation insurers especially UnitedHealth and its subsidiary Ingenex.  Cuomo alleges that Ingenex, which is used by multiple insurers, produces false information for insurers regarding the usual and customary charges from physicians and hospitals. This means patients need to pay more out of pocket when they see out of network providers.  This may end up to be very expensive for the insurers. If this goes national the expense may be many millions of dollars per insurance company and even more for Ingenex and its parent United.       Top


Harbor UCLA is in peril of losing their Medicare money due to problems in their ED.  The investigation started after a patient left the ED without being seen due to a long wait time.  He was found dead the next day across the street.  He died of diabetes, renal disease and had cocaine in his system.  He had waited over five hours to be seen and the staff did not miss him for eight hours.  This is another in a long line of problems for hospitals run by LA County.  King Hospital closed and there have been investigations of deaths at Olive View-UCLA and the USC facility.

Now the LA Board of Stupes is considering closing the clinics due to budget problems.  This will increase ED usage and payments significantly.  It will also put people out of work and they will leave to seek employment.

San Francisco General, run by San Francisco, will have to delay elective surgeries and close their worker comp clinic due to a lack of funds by the city. The city is to have a $233 million deficit for the coming year.      

Although not a hospital, the FDA has fine the Red Cross $4.8 million for the distribution of unsuitable blood products.  This is on top of the previous fine of over $15 million in prior years for their poor performance.  The Red Cross stated that the fine would not be paid via money collected through donations but would be paid by hospital payments. The motto is to self donate if possible.        Top


New York is now getting into the physician offices.  Starting in July, 2009, a new law will require office surgery, especially in urology, plastic surgery and endoscopy units to be certified in the state.  This will be done by that great bastion of common sense, The JC.        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.