July 15, 2014 Recent News






An audit of Obamacare exchanges showed they did not have the safeguards to check the recipients eligibility.  They also could not verify the need for subsidies.  In other words, they were inept.  The system was and in all probability still is not ready to do the job.  Tavenner says the problems are not surprising since it was the first year.  She blamed the problems on consumers inexperienced and making application mistakes.  She said nothing about the computers themselves.  Sebelius lied to Congress when she certified the exchanges were verifying eligibility two weeks prior to the onset of subsidy payments.    

The VA exodus continues.  Dr. John Pierce, the head of the medical investigation unit, resigned.  He and his useless unit were blasted by reports of failure to investigate instances reported of poor care.  They whitewashed it all.  

The Washington Times has a story that the VA has paid out over $100,000 in bonus money to senior VA officials who ignored whistleblower complaints of poor patient care in their facilities.  

Two years ago the VA started an internal audit and found many employees were mis-catagorized.  This caused them to get too much pay.  What did the trusted VA do?  They stopped the audit and continued to pay the staffers.  Not only that but they continued to hire at too high a position (higher GS level).  The VA states they can not recoup the erroneous salaries and must continue them.  They continue to resist any changes and are not following federal law.  There needs to be a full scale removal of all senior management in the VA system.

The American College of Physicians (internists) have come out with a statement that women who have no health problems do not need an annual routine pelvic exam but should have a Pap smear.  They believe that the potential harm outweighs the potential benefits.  It should be noted that the organization is one of physicians that probably do not do pelvic exams on a routine basis and are not very good at it.  The College of OB/GYN immediately responded that the exam should be done.  The do it routinely and are good at it.  

UnitedHealthcare has done yet another round of axing physicians from their Missouri Medicare Advantage program.  They are using the no-cause termination clause.

The NYT says that longer waits for physician appointments are now the norm.  This should surprise no one.  There are more patients and not more physicians.  Physicians are now employees and leave on time.  They used to squeeze an extra patient or two in a day but now, no.  The more our healthcare system becomes more like Canada or England the fewer patients will be seen.  The incentive is gone.  When we are compared to foreign countries we must use our government based healthcare as a comparison.  We all saw the result of the VA healthcare waits.  We saw the unions making sure no surgeries were done in the afternoon so they could leave on time.  We saw the administrators using false lists to make sure they got a bonus.  

USA Today has a story about the wonderful electronic medical records and how they are directly leading to medical fraud.  There is no requirement that any audit software be on and so the records are vulnerable to changes.

Politicio also has a story on EMR.  They state that they are ripe for theft.  A single full profile will bring on the black market about $500. This compare to about $1 per stolen social security card or credit card.  When a hacker can get over 100,000 with one hack it makes economical sense to go after the weak link.  With all the recent EMR in physician offices and hospitals the ability to protect the records has woefully lagged.  Think of how easy an identity theft would be with all the personal information in a health care record.  To date almost 10% of the American population has had their information accessed. 

CMS wants to know if Medicaid recipients can really find physicians and at what ease.  They are doing nationwide research on this to see if fee for service or HMO Medicaid is any different.  Many states already do this collection of data but CMS wants their own questions which will go out this fall to about 29,000 enrollees.  

The NYT reports that the new Obamacare recipients are happy campers.  They should be.  Those polled had pre-existing conditions that made them uninsurable in the past.  This is a good thing of Obamacare.  It also showed that all the money went to insure 5% of the under 65 crowd.          Top


You have heard the Christmas song "How Much is the Dogie in the Window?", well the new song is " How much is that CEO in the Hospital Worth?".  Medscape has an article regarding the worth of CEOs versus physicians.  It is not close.  The highest paid physicians are Orthopods and their average is $413,000.  The average for the 11 largest for profit medical insurers is $11.3 million.  The CEOs of biotech average $18.3 million.  Non profit hospital CEOs do not make the highest paid list since they can not get stock shares but do not feel sorry for them since the average salary is $600,000.  The physician states that he should be paid more since he/she went to medical school and work long hours.  The hospital CEO is in charge of everyone in the hospital including physicians and nurses.  Who is worth more?  The IRS looks at the salary of non profit hospital CEOs but can do nothing about them except to publicize how much they make.  The People's Republic of Massachusetts dumb nurses are again attempting to make stupid rules.  The latest is that a hospital CEO can not make more than 100 times that of the lowest paid person in the hospital.  The figure is arbitrary and has no rational basis.  The California SEIU also wanted a ballot measure to cap CEO pay until the hospitals agreed to some of their blackmail.  The only way to look at CEO pay is supply and demand.  The only way to look at physician pay is via the RVS.  The two can not be compared.

Maryland's Anne Arundel Hospital is banning new employees from smoking including e-cigarettes anywhere in the world forever.  This practice is legal in almost half of the states and in 29 states laws have been passed to forbid the practice.

In a fascinating article the Becker Hospital Review reported on the Aspen Conference.  At the conference Toby Cosgrove, the CEO of the Cleveland Clinic and the person who turned down Obama's offer of the head of the VA, stated that community hospitals that can not sustain themselves should be closed and the patients go to regional hospitals where they can get better healthcare.  He also said that at the Clinic they have one year physician contracts.  If the physician does not perform highly they are history.          Top


UnitedHealth has reported on a three year study paying oncologists in several areas a pre-payment for an entire episode of care including drugs.  There was additional payments for hospital visits.  The study found less, by 1/3, costs to the insurer.  There were much less studies but they found drug costs increased dramatically due to unknown reasons.        Top


The Miami Herald has a story about the south Florida physicians who will not take patients with Obamacare.  That is their right unless they are contracted via an insurer to take all comers.  The physicians do not like the paperwork, collecting the co-pays or the potential of not getting paid with the exchanges due to the 90 day rule.  The story was one sided with the patients getting the short end of the stick not the physicians who for legitimate reasons will not see these patients.  They used words like humiliated when describing patients.  Yellow journalism.


 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.