May 15, 2014 Recent News





The administration has stated that about 8 million people have "enrolled" in Obamacare via the site, about 63% white and 54% female.  About 66% chose silver (mid-range) plans.  See below.

The House Committee on Energy and Commerce reported that the information from the insurance companies state that about 66% of those "enrolled" in Obamacare have actually paid a premium.  Since the exchange is still in the 20th century Sebelius states she doesn't have a clue about how many have paid their premium. Two thirds of 8 million is 5.32 million.

The president of CGI the company that was hired to build the website has unequivocally stated that the company has never been fired from any federal healthcare business.  Accenture, the company the feds have hired to go forward with the site has inked a contract worth $121 million for one year or about $30 million more than what was thought to be needed.

The Bureau of Economic Analysis has reported that healthcare spending has increased almost 10% in the first quarter of this year.  The reason is Obamacare.  This is the larges quarterly increase since 1980.  It is an increase in utilization and not pricing.

A study by Stanford University and published in Health Affairs showed that the purchase of physicians leads directly to higher costs.  This goes against the argument of the hospitals that buying practices reduces costs.  The feds promoting of ACOs has accelerated the purchasing of physicians by hospitals and insurance companies.  This study may help the FTC in challenging the purchase of large groups of physicians.  The AHA predictably challenged the study saying it was outdated and did not look at physician spending only hospital.  The study only went to 2007.  

In another blow to the AHA a study from the U. of Louisville in the Journal of Health Affairs again showed surgery in ACOs is quicker and cheaper than at hospitals.  They also showed the outcomes were the same.  They predict that hospital outpatient surgeries will increase by 8-16% per year through 2021.  This is fodder for reducing hospital payments to that of ACOs or at least meeting between the two.

In still another driver for increased healthcare costs is the shift of chemotherapy from the physician office to the hospital outpatient department.  The shift is due to the combination of increasing costs of the medication and the purchase of oncologists by hospitals.  Hospitals can charge much more for the giving of the meds than physicians.  The increase is actually triple over physician offices.  

Last month I reported on the terrible situation at the Phoenix VA.  The VA has done an investigation and found no secret list and no patients that have died because of the secret list.  However, the top three at the hospital have been put on leave during an investigation.

In the Fort Collins, Colorado VA investigators have apparently been told that employees were instructed to falsify records to make appointments were made close to the day requested.  The VA said this was a training issue and therefore no one was disciplined.  The records obtained by the AP were redacted so it is unknown who told the employees to falsify the records.  

Because of the uproar, there will now be an investigation into all the VA system in regard to their appointment policies.

In the wake of the above stories and many other problems with the VA the American Legion has asked for the resignation of Secretary Shinseki.  The White House defended Shinseki again.  Shinseki was a four star general who served in Nam.

The House has subpoenaed Shinseki and other VA officials about the Phoenix wait list.  The subpoena entails all emails and other correspondence regarding alternate wait lists.  The subpoena became necessary due to what the House said was stonewalling by the VA.  Shinseki had told the House that a "interim list" on a spreadsheet may be the alternative list but the spreadsheet had been destroyed.   

In an article in JAMA that explains Medicare fraud, the researchers showed that in 2009 Medicare may have spent at least $8.5 billion on unneeded or unnecessary tests.  The problem is that the tests may be OK for the individual but not in general.  How does one know?  The main thing the study shows is that the time lag is much too long.  They did the study on 2009 data in 2014.  This leaves five years to cheat the system and get out of Dodge.  The article said the tests may be ordered for patient preference, malpractice prevention or fraud.  They had no way of knowing.

The day after I wrote the last paragraph HHS and the AG indicted and raided multiple cities and arrested 90 people for health care fraud.  The raid included 16 physicians.  There was no real reason for the raid as the crimes are not linked and could have been arrested separately.  That would not have made the news.

Is Canadian health care free?  Of course not.  The Canadians pay for it via taxation which pays for health insurance.  The cost as figured out by the Fraser Institute shows if all Canadians paid tax would be $3870 per person.  The average Canadian family cost for healthcare insurance increased between 2003 and 2013 more than 1.5 times the average income increase.  The 10% with the lowest income paid about $482 in 2013 and the 10% who earn $56,596 paid $5,364.  The highest 10% paid in 2013 $35,309.  On the other side, this is the total cost of the care for that family for that year.

Don Berwick is running for governor in the People's Republic.  He loves the British healthcare system and wants to put it in in the Republic as a single payer system.  He is in love with not only the idea but with the power as he wants to be the czar.

Politicians are politicians.  The DC council has plans to tax health insurers 1% on all policies sold in the city.  This is to pay for the exchange.  The policies taxed would include disability, long term care. vision, dental, worker comp and hospital indemnity.  They want this money to take the place of money to be lost when the feds stop paying in 2015.  The insurers will sue to stop the tax and all the council does needs to be approved by Congress.

The NYT has a front page article about the narrowing of choices for hospitals and physicians or the high cost if one wants more choices.  The article states the inability to know who is in the network prior to signing up for insurance.  The feds are insisting on some changes in the upcoming exchange signups.  It seems as usual people are choosing price as more important than the physician or hospital.  Medical care is now fungible.  Physicians and hospitals are now competing with low prices to get into the networks.  They are their own worst enemies.  The employers are now following the same narrow network plan and are also looking for the low price spread.         Top 


Bloomberg has done a hatchet job on physicians.  In an article that could have been good (it wasn't) they went after a physician who (they state) billed Medicare legally for services rendered.  They intimate that the services were not needed or necessary but have no proof either way.  They quote the head of a physician unfriendly group saying physicians who lose their license in one state should not practice.  The article could have been good if they would have gone after more the people in the Medicare administration who have done nothing to fix the ability to easily commit fraud.

Allina Health did an experiment.  They figured out how many patients their physicians were seeing per hour in the ED using EHR.  Then they used scribes and almost doubled the patients seen per hour without any decrease in patient satisfaction.  The cost is a whooping $8-$16 per hour.  Also noted was a decrease in door to bed times was seen at the U of Maryland.  In the future as tech gets better scribes may be a thing of the past but as for now they are wonderful in the ED.          Top


The California Hospital Association caved to the SEIU.  The hospitals have agreed to a "code of conduct" in union organizing.  In return the union will drop its push for a cap on hospital prices and executive compensations.  Together the two organizations will push for a legislative increase in Medicaid prices to providers.  

Aspen Valley Hospital somehow got it wrong.  On Christmas eve they handed the only surgeon is employment walking papers and loss of lease 6 months later.  They hired an outside surgical service to take over the trauma and ED.  The community found out about the ouster of the 20 year surgeon and packed the hospital board meeting.  They were not happy campers and even a member of the board said that the meeting showed they had done something wrong.  Will the surgeon be allowed to stay on the staff? Yes but will be on call 24/7/365.  Untenable.  Assuming the medical staff is also unhappy about the switch the new surgeons will get no referrals and will leave after the one year contract.  The hospital will then be forced to again deal with the surgeon but on less friendly terms.        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.