May 15, 2010 Recent News
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The American Board of Anesthesiologists is going where they should not. They have threatened to revoke the Board certification of any of their physicians who help in the state or federal executions by lethal injections. This will have a chilling effect especially in states where a physician is required to attend the execution. It is doubtful that if anyone was actually excommunicated and sued that it would stand up in court since the procedure is legal, morality aside.
California physicians should be afraid. The hospitals of southern California are attempting to create a single foundation to employ physician groups. This would mean the end of private practice in the state. The groups would still be at individual hospitals but be employed which is against the corporate practice act in the state. This is the way to get around this important law. The foundation could shut out any competition and the combination of physicians with the hospital could raise the specter of antitrust with the insurers. Top
The Wall Street Journal had an article on the problems of college healthcare. Colleges and universities overcharge for the care and their pamphlet explaining the care are confusing probably on purpose. Many make students take the insurance unless they can show they are covered under another plan. Others make them take the insurance even if they have outside insurance. The problem is then who pays for the care. A recent study showed that colleges overcharge between $2.3 to $2.8 Billion per year on their plans. The colleges love to tack on extra charges including late fees. If the student doesn't pay they don't get their transcripts or registration.
In Obamacare there is a temporary slush fund of $5 Billion. This the White House states will be used to help fund early retirees with their health care premiums. They will reimburse 80% of claims for those without insurance between the ages of 55 and Medicare. This will last until the new exchanges come into being. Of course, Sebelius stated that if the money become short before the exchanges kick in no new people will be accepted.
The insurers are waking up to what is in the healthcare bill. They now realize that they may not be able to meet the spending mandate of 80% of premiums be spent on individual coverage. Marketing and administrative costs may be higher in individual policies. Starting soon those insurers that do not meet the requirements will have to start issuing rebates to the policy holders or leave the individual market. By 2014 it should not be a problem since then there will be exchanges and no pre-existing conditions.
To make matters worse, the Senate is going to consider a bill that would control the premiums that insurers could charge. This would complete the government takeover of medicine as there would be no negotiations. Hopefully the Republicans and Democrats can agree that this is folly.
The Washington Post had an article talking about the 33 states (yes, that is 33) that are moving to legal and/or legislative challenges to Obamacare. The article states that there will be multiple challenges to the new law and if one challenge is beaten down another one will appear.
A study by Millman showed that spending by families of four will increase by 7.8% in 2010 and employer costs being raised 8%. This is based on PPO coverage.
In the same vein, the CBO has revised its estimates on the cost of Obamacare. They have increased the costs by $115 Billion due to estimated discretionary costs to federal agencies for the implementation. This brings the total cost to over $1 TRILLION and still does not include physician payments.
In an interesting article researchers at Cleveland Clinic reported in Cancer that removing kidneys for cancer in the "elderly" may not be a good idea. The report states that "only" 4% of the people die from their cancer. It does not state that those with the cancer confined to the kidney can be cured by surgery or how one would like being in the 4%. They say surgery is ok if localized and not a total nephrectomy. Top
The Access Project released a report stating that non profit hospitals do not tell patients about any charity care in any helpful ways. The hospitals are supposed to have clear written guidelines as to how to help patients determine if they qualify for charity care. The report states that only 25% of the non profits provide eligibility information. Less than 10% listed discounts for different income levels on their web sites. This shows that the non profits only give lip service to charity care and that they need to be regulated more by both the states and the feds and if not compliant lose their non profit status as did Provena in Illinois. The AHA attempted but failed to provide their non conforming hospitals with cover.
Speaking of non conforming hospitals, the LA Times reported that Olive Grove, UCLA has had multiple fines by the state for poor quality care over the last three years. It is amazing that a hospital affiliated with a medical school can be this bad. However, we have seen the same thing in Massachusetts.
Other problem hospitals are the VA. However, they recognize it and take precautions. The VA has now limited the types of surgeries performed at five hospitals and will pay for the transportation to hospitals that can do the surgeries safely. The five VA hospitals that are sub standard are those in Alexandria, Louisiana, Beckley, W. Virginia, Fayetteville, North Carolina, Danville, Illinois and Spokane, Washington. Top
The feds are crowing about their anti fraud effort getting $2.8Billion back into the system. I agree this is good but not having to get it back would be better. They still can not run an insurance company to deter fraud instead of suing to get the money returned. 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.