June 1, 2009 Recent News




Obama recently gave a press conference after a meeting with representatives from various healthcare organizations.  He reported that these organizations had pledged to reduce healthcare costs by 1.5% per year over the next ten years.  This is not what the organizations state they said.  They state that they agreed to over ten years slowly ramp up to the 1.5% decrease.  This is a far cry from what Obama stated. Maybe, like Pelosi, he didn't get the message.  Also it should be noted that many of the most important players in the healthcare field were left out of the meeting.  They included the AFL-CIO, Blue Cross Blue Shield, nurses, ambulatory care centers, home health and the most important of all, patients.  It's still better than the secretive Hiliarycare but still has a way to go.

He did request that the stakeholders return in June with specific plans on how they can reduce the costs.  The one that will reduce up to 20% easily will not fly, change med mal rules.  The trial lawyers love the Dems and the Dems love the trial lawyer's money.

There is a slight problem with the stakeholders getting together with their recipients, it is illegal.  There is an antitrust law that forbids hospitals, physicians or other entities to band together to raise or lower or otherwise fix prices.  The FTC has already issued a warning to the affected groups.  Obama in a separate of his many speeches has vowed to step up antitrust enforcement.  This is not good for his healthcare proposal.  The FTC nixed both Carter's plan to reign in hospital costs on a voluntary basis in 1976 and again with Clinton's attempt to get pharmaceutical costs under control in 1993.

In the antitrust arena, ConnectiCare has cancelled its contract with a 175 physician group due to the fact that they would not accept a 6.2% decrease in fees.  The insurer hopes to get the individual physicians to sign up since they are not to collude not to join.  They all now know the ridiculous price offered and if they do join they are as stupid as the insurers believe they are.

Medicare has no idea how many payment errors it makes for DME says a new report by the IG of HHS.  He says that about 70% of payments for 2008 should not have been approved.  Medicare believes the error rate is about 10%.  The Senate believes Medicare knows not what it does.

The Congressional Budget Office has stated that to change the way physicians are paid will be very expensive.  The most logical payment is the same as last year plus a cost of living increase.  That would cost over $340 Billion over 10 years.  Another plan is to remove outpatient drugs both retrospectively from 1998 and prospectively.  That would save almost $100 Billion.  If just cutting the drugs prospectively there would be a $10 Billion savings.

Never fear.  UnitedHealth has a way to save the country.  Their solution is only have patients see physicians that don't do lab tests and don't charge very much.  Quality has no place in their equation.

To balance the above, it should be noted that there has been a steady decline in cancer deaths over the past several years.  Women have seen a 12% decrease and men a 19% decrease.  This translates into 650,000 people alive due to early testing and better treatments.  

The AG Holder has announced increased Medicare surveillance in Houston and Detroit where there seems to be increased abnormal billing activity.  Of course the feds are going after people who have cheated instead of trying to find them early.   

California has come up with a list of 28 procedures and what the uninsured would pay for those procedures at all the hospitals in the state except Kaiser.  Kaiser is an HMO and therefore can not be compared.  They are compared as to length of stay for the procedures.

Sen. Baucus believes that health care for all but illegal aliens will be passed by this summer.  The far left, led by Sen. Kennedy, wants there to be a government run insurance program.  This would be a killer to the Republicans.  All realize, but do not state, that whatever they come up with it must be paid for.  When the numbers come to reality I wonder what they will cut.  They hope to raise some money by doing what McCain stated and was blasted by Obama for, taxing health care benefits.  Reconciliation of the bill would be disastrous for all. 

As most know, Obama has in his stimulus package just over $1 Billion for what is called "comparative effectiveness research."  There was recently a blog from an Oncologist professor of cancer medicine and former head of cancer control at WHO in Great Britain regarding their effectiveness research performed by the National Institute for Clinical Excellence (NICE).  She stated that many have died due to the inability of the use of new chemotherapeutic drugs due to cost.  Britain's NICE makes sure their is enough bang for the buck.  They keep out of the hands of the practitioners all drugs that are expensive, such as only about 10% of the drugs available in France.  This causes Brits to die earlier.  The Swedes survive cancer at a 60% clip, Brits at a 40% rate. Although NICE is supposedly non-political that is not the reality. It should be noted that the socialist countries do not have the same type drop in cancer deaths as the United States (see above story).  I might add that when I did some training in London, I witnessed some of the best surgeons I have ever seen and they were also the rudest people to the patients that I had ever seen.  We have alot to look forward to on this side of the pond.      

A company that thrives on publicity comes out every 6-12 months with some stupid story about medical boards not disciplining enough physicians or now hospitals not reporting enough doctors to the NPDB.  They work only on raw numbers and never take into consideration any reasons for the numbers.  This organization only sees the potential devious motives. The California Hospital Assn. responded stating that the idea is to not get rid of physicians but to continue to allow them to be good members of the medical community.  This may mean giving them proctors or other such methods.         Top


Medscape Medical News had an article stating that physicians and hospitals should not purchase electronic record devices yet no matter what they are told regarding the 2011 deadline by the vendors.  The feds have not determined and will not until at least the end of this year what type system will be needed and how the systems should be used.  There is no agreement as to what "meaningful use" of the equipment is nor what "clinical quality measures" must be reported.  Also you must be able to exchange data with other providers, do prescribing and the system must be certified.  There are no certified systems in place as there is not a definition of certification, again no matter what the vendors tell you.  

Still another site has been hacked.  Aetna's site was hacked and they are paying for 65,000 people who are either working with the company or who applied to work to get credit checks. The people told the company that they were getting phony emails telling them they had a job and wanting more information such as address.     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.