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The People's Republic is getting so much press that it now deserves its own heading. The idiocy that is the Republic's healthcare is continuing to pave the way for why universal healthcare is not good for the people of the country. This is a small state that has tried the experiment and is failing badly no matter how the PR people are trying to spin it. The residents of the Republic are not spending approximately 10% of their net pre-tax income on health matters. About all of these are insured. This is almost a 50% increase since the experiment started. The premiums have increased and the meds and services have decreased. The costs in the Republic are rising faster than the remainder of the country. This is typical for government healthcare. Look at Canada and England where healthcare premiums get a person a place in a line for treatment and not treatment.
As the lines grow, the wait times increase. Boston now leads the nation's 15 largest cities in wait times to make appointments to see providers (not physicians, they are different). It takes two months to see an primary care physician, if you live that long. Only about 55% of the offices accept Medicaid. I am surprised it's that high.
The Republic's "government" is planning to pay the providers and the hospitals by a methodology that looks alot like capitation. They want to move quickly but need approval from the feds for Medicare and Medicaid patients as well as buy-in from the providers of the care. The new capitation system would provide stop-loss insurance by the Republic for those providers that get stuck with a high cost patient. The providers would also be paid more for those patients with high cost diagnosis. The Republic would like this in place in three to five years at the longest. That should be enough time for the physicians (not the providers) to find new places to practice. Top
Ain't the electronic age wonderful. We can now put our medical records on line and allow the world to see all. The University of California was hacked and all the hackers got were the names and SS numbers of multiple thousands of people but no medical records. At the Virginia Prescription Monitoring web site it was different. The hackers got all and are requesting a $10 million payoff which the state will not pay. Last year Express Scripts also was hacked and payment was requested. I do not know if any was paid.
The feds want all to become computer people in the healthcare arena. They want everyone to be "meaningful users" of the medium. Problem is that no one can agree to the term. Every outfit is looking after their own and not the common good. This usually means nothing good will come of the term. Top
What happens to your ability to treat and bill Medicare if you switch accreditation organizations (AO)? Nothing! One can quit any AO and move to a different AO anytime one wants. There are three AOs. The first is the JC, the one most should move from. The second is Healthcare Facilities Accreditation Program and the third is the new NAIHO, which uses the ISO 9000 methodology. If the current AO stops your accreditation prior to the new one accrediting you, the State will take over for the interim. All are better than the JC who make up their own rules with little regard for the Medicare rules.
Several South Carolina hospitals are moving to the new NAIHO due to the inflexibility of the JC. To date the fledgling organization has accredited about 20 hospitals nationwide. The major difference is the new organization wants to know you have accomplished a standard not how you have done it. Top
The feds have decided to reduce the payments to fee for service Medicare Advantage plans as well as have them by 2011 develop provider networks. These two have encouraged WellCare and Coventry to drop the programs. The former has over 100,000 people insured and the later over 300,000.
The San Francisco Business Journal reports that Kaiser's first quarter went from a net income of $250 million a year ago to $430 million this year. They had a 5% increase in operating revenue over last year. They continue to lose money in the stock market like the rest of the country. They also added an another 12,000 lives in the quarter. Top
If people want to know why healthcare is expensive they need to look at both the legislators and the insurers. The legislators give unfunded mandates as to what must be covered by the insurers without any thought as to the cost to the insureds of this coverage. The insurers also make it expensive and difficult for the physicians to take care of their patients. In an article in Health Affairs it was found the average physician spends three hours weekly interacting with health plans with nursing and other staff spending much longer times. Nurses were spending over 19 hours a week mostly for authorizations and clerical staff an additional almost 30 hours per week for billing problems. Most physician time was on formularies. The total average cost per practice was $68,000 per physician per year. This comes to between $23 BILLION and $31 BILLION per year wasted money. 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.