August 1, 2014 Recent News






Burwell is taking up where her poor predecessor left off.  In an unneeded tout of Obamacare he stated that in the state exchanges the government (taxpayer) subsidies dropped the average monthly payment from over $300 o $82.  This was a saving to the individual of about 76%.  Great for the individual.

What has Obamacare actually done?  It has decreased the uninsured Americans by 1.6%.  The numbers are 16% to 14.6%.  These numbers are from the CDC.  

Kaiser has found the 40% of the newly insured under Obamacare had prior insurance.  The vast majority of those do not speak highly of Obamacare.  The majority of those  60% who are now newly insured and with subsidies like the plan.  The proof is in the pudding.  If the newly insured are able to pay their co-pays when they actually use the insurance it will be a good thing for them.  

A new Senate report shows that the Obama administration was well aware of the forthcoming problems with the website.  The warnings started one year in advance of the disastrous opening of the site.  The report blasts the wasteful use of public funds on something they knew would fail.

Moody's states that in ten states Obamacare premiums will increase between 8.5% and 22%.  Moody's goes on to state while these numbers are good for insurers the overall outlook for the insurers for 2014 is bleak.  They state that premiums will increase over time as new meds and procedures are integrated.  It is expected that premiums will increase on average by 10% this year.

The VA scandal has shown that if the feds want to hire more physicians at the VA they will have a hard time.  A poll has shown that only 2.5% of practicing physicians want to work at the institution and only 1.9% of those in training.  The physicians are willing to take care of vets but in the private setting.

VA physicians have accused the organization of demoting employees or firing them for speaking up about the problems at the hospitals.  The new acting VA secretary has acknowledged the retaliation that has gone on and vows to stop the harassment.  The VA needs to pay all those retaliated against money out of their budget that would have gone to pay bonuses to the administrators.  

In a statement that can not be believed, Dr. Lynch of the VA administration stated before Congress that he is unaware of any allegation that the Phoenix VA is still buggering up their wait lists to make it look like no one died while waiting.  Why are these people still allowed to administer the program??  This came after a new allegation from the person who administered the lists stated that the VA is now in a cover-up mode.

Ms. Lerner, the head of the Office of Special Counsel, sent a letter to Obama blasting the VA for its long term handling of criticisms about the care.  She blasted the VA for ignoring whistleblower complaints and the retaliations.  It remains to be seen what the overseer does. He probably will condemn the terrible things that are happening but nothing else.

The purge has started.  Two VA officials are leaving with good riddance.  The acting under secretary for health and the general counsel are gone.  A good start. 

Healthleaders has a wonderful editorial piece relating to the VA scandal.  It rakes the legislators for throwing more money on a corrupt system and allowing it to flourish.  The piece recommends the common sense approach.  Gut the VA and allow all vets to enter either Medicare or Medicare Advantage instead.  

The Obama investigation of the VA showed a terrible organization that in true Democratic fashion can be fixed with money.  The recognize the horrendous culture that has spawned the worst medical system in the country.  The report also showed the VA has ignored the prior recommendation for fixing the system.  It continues to be a fascinating exercise in the government to deny the fact the VA needs to be gone. 

The administration said Obamacare was responsible for the great first quarter GDP.  Now they need to eat their words.  It turns out that Obamacare led to decreased healthcare spending and a significant drop in the quarter's GDP.

Modern Healthcare reports the obvious.  Under Obamacare those who lacked coverage went to Medicaid not private coverage.  States that adopted the expansion saw their uninsured rates drop by 4% as opposed to 1.5% in the other states.

In yet another new regulation the administration stated that renewal of Obamacare coverage could be done automatically.  People who do this however are idiots.  One should always reassess the pros and cons of each policy offered.  This is being done for politics and for those only in  They do not want a repeat of last year's fiasco.  How does one tell whether the subsidy is too high or low?  They can not without going back to the site.  If someone's IRS form shows changed circumstances they may be hit with the huge Obamacare monthly payment.  This is even more so as the premiums will increase next year.

New York's big soda ban is no more.  A court stated that the regulation went beyond what it could do and is now null and void.          Top


A so called consumer group has asked twenty hospitals to stop marketing medical tests to the patient.  The tests are those that the group deems unnecessary and unethical.  The tests include taking pictures of the heart, doing EKGs and ultrasounds of the vessels.  These tests are usually done in conjunction with another organization, HealthFair.  

Some California hospitals will be shown in the media as being poor places to be.  They will be, if the media looks, those hospitals that do not have a partnership with the SEIU, a healthcare union.  These hospitals such as Cedar Sinai in LA refused to sign an agreement with the union to make it easier to organize workers at the hospitals.  The sheep hospitals were so afraid of the union's ability to criticize them they buckled.  As long as majority of hospitals signed the agreement the union agreed to spend $20 million to help increase Medicaid reimbursement to the hospitals.  This money would go to pay more wages and benefits to the workers.

The Tenet hospitals in the Coachella Valley California (Palm Springs, Indio) want to  fire their in house physicians and contracting with physicians from out of the area.  They state they want to keep the physicians they put out of a job on their staff.  They just want to pay less for the scabs.  The medical staff of the hospitals were not consulted on this and are against the idea.  The CMA has begun to become involved and could eventually file suit if the hospital continues unchecked.

The Massachusetts Nurses Union has aired an attack ad against hospital CEOs in general.  You know there is more behind the ad.  In reality the union wants the hospitals to stop paying the CEOs their salary and pay their union employees more.  Even better, hire more to pay dues.  They want the information that is now proprietary about how much hospitals profit so they can get more for themselves. 

The NIHCR states that hospitals charge significantly more for the same tests or procedures than ambulatory care centers or physician offices.  The blame for higher than necessary healthcare costs seems to focus more and  more on them.  It is obvious that insurers should steer patients away from the hospital to more value based ASC or physician offices.  They should never allow hospitals to charge facility fees in the physician offices that they have purchased.        Top


The independent physicians of California are pissed.  They have no one to represent them in the legislature.  They have joined together into the California Integrated Physician Practice Association.  They have about 200 independent physicians.  They will work to defeat legislation such as the recently defeated bill in the legislature that would have prohibited physicians from offering advanced imaging pathology, radiation therapy or PT in a private office or a group practice office.  The hospitals would have loved the bill.  The group worked to defeat this bill and will work as a lobbying group.

A new business Aledade was formed with venture capitol money to work with independent primary care physicians to be able to join ACOs.  The business will outfit the offices with EHR and other upfront costs.  There will be a fee to join of about $1000.  They have contracts with physicians in New York, Delaware, Arkansas and Maryland.

Becker Hospital Review reports than 21% of the physicians interviewed by Medicus would not enter the healthcare arena if they could do it over.  A huge percentage.          Top


UnitedHealth continues to cut physicians.  This time it is in Missouri.  The second round of cuts in the state in Medicare Advantage plans will have removed between 5% to 7% of the state's 10000 physicians.  This round seemed to remove dermatologists.  It left some counties with no one to perform Mohs procedures.  The plan really doesn't care about their insureds.

California has launched a probe regarding the narrow networks of Blue Cross and Blue Shield.  They want to know if the provider lists were wrong and what is the cause of the problems with access.  They are calling physicians to see if they are enrolled and if they are taking new patients.

Insurers are finally getting smarter.  They are not going to reimburse hospitals for chemotherapy more than they reimburse in the physician offices.  Hospitals had been racing to "integrate" oncologists to the hospital so they could bill for the chemo at the higher prices.  Now they have the oncologists and will not get the big reimbursement.  Highmark has already done it and the rest should soon follow.  It is almost 190% higher charges in hospitals than physician offices for the same medicine delivered by the same physician in the same location but it is now a hospital department.        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.