November 15, 2013 Recent News





In the past month there have been multiple stories in the news about the Obamacare fiasco of the federal website and the loss of insurance for individuals with huge increases in premiums.  I can not list them all but I will list the ones I feel are the most important.

Those who buy insurance via the exchanges under Obamacare will be left out of the ability to enter most of the top US News and World Report hospitals.  They are opting out of Obamacare and many of the others are only in a fraction of the total insurance packages offered.  Some websites in the areas that web sites are working like California do not tell which hospitals or physicians are on which insurance package.  The insurers are dropping a significant number of good physicians due to cost and not quality.

Would you believe that just 6, yes 6, people signed up for an exchange in the first day of the federal exchange.  The six are with five different insurers.  In the first month of Obamacare almost 90% of the signups are Medicaid.  This will be a major problem for states and the feds who will have to pay for the Medicaid folk as the feds pay only for new enrollees and the state pays for those who were eligible prior but never signed up.  This will also mean a significant problem for insurers who need the young healthy to pay for the older not so healthy people who are or will be enrolling.  

Oregon signed up almost 60,00 people for Medicaid and none for private insurance due to their own state website failure.  Medicaid enrollees do not pay any co-pays and don't have choices. 

One of my subscribers sent me a note regarding the State of Washington.  The doctor said that of the 35,000 sign-ups 31,000 were for Medicaid.  He ponders why the need for an exchange for that.  Why not just enroll them directly?  He also states that the exchange asked for MONTHLY INCOME but the feds want ANNUAL INCOME.  The feds read this as annual and therefore said that many who are not eligible well be subsidized.  It should be fun when they want their money back. Do you remember Jessica Sanford?  She was the woman with a ADHD child who Obama said was the face of Obamacare.  Not any more.  Her story of going from being uninsurable to one with an affordable plan is now a fiction due to the Washington state screw-up mentioned earlier in the paragraph.  Originally, she was quoted $198 per month for her insurance but when the subsidy mistake was found her coverage would cost $324 with a high deductible.  She is now going to pay about $95 for no insurance. 

Even in California where Covered California is working well out of the first 80,000 sign-ups only about 30,000 are private.  Only 1/3 were not eligible for some kind of subsidy.  

To go with the inequity of the people signing up to date are the others who are losing their insurance.  Most individual and some group or employer insurances did not cover all the government mandated issues. Now, they must.  That is wonderful for the people in their 50s and 60s who now get their needed maternity care.  To make matters worse the government now believes that almost half of the employer sponsored plans will be cancelled.  This is a far cry from the Obama statement of a few days ago that only less than 5% of the population (15,000,000) will need to change their health plan.  Another of many misspeaks by Obama.  Obama also promised that premiums would go down.  This also is not the case.  You know Obama is an attorney as he lies with each mouth movement.

Obama, after being chided by Clinton, decided on another executive fiat.  He stated that he would not impose sanctions on those individuals who kept their old insurance even if it wasn't up to the Obamacare standards and asked the insurers to allow the old plans to continue for another year.  Of course, he can not do this.  This is controlled by the states and the insurers.  He has been rebuked again as most of the state insurance commissioners will not allow the old plans to be sold.  Even his own administration concedes that his "fix" would weaken the exchanges and drive up costs on the exchanges.

On November 20, 2013, just 11 days until the exchange was supposed to fixed, almost 40% of the back office function have not been built.  This bodes poorly for the administration.  

Obama stated that he did not know about the problems.  He is either a liar or incompetent.  In March his administration hired private consultants to assess the progress of the website.  This was at a presentation to CMS and White House personnel.  They stated that the problems were huge and that the October 1 opening was going to be a disaster.  They were right.  

It appears that just 44% of the country's physicians will participate in the Obamacare program due to low ball payments and rationing of physicians available by the insurers.  This does not bode well for Obama's promise that if you want to keep your physician, you may. 

I just found out that in the Obamacare law there is a clause that allows "direct primary care" (concierge medicine) to count as ACA compliant insurance as long as there is a wrap around catastrophic insurance policy.  This will allow those who wish and have a difficult time seeing their physician or finding one to go to concierge medicine.  It should be noted that these practices have begun to increase in number and charge much less per month that the original ones did.  There is a problem, however.  The IRS does not recognize direct concierge fees as allowable under HSA rules.  Therefore one might not be able to use pre-tax dollars at the practices.

Bowie College, a black college in Maryland, has decided that it needed to cancel its student healthcare.  In order to comply with the new Obamacare rules they would have to raise premiums from $50 per semester to $900.  They found it better just to drop the program.  

Did you know that WebMD has a $4.8 million contract with the feds to promote Obamacare?  It didn't think it had to disclose this fact when it hyped the program.  Therefore, please take all their editorials about Obamacare with a grain of salt.         Top       


The feds boosted the statin industry with a new guideline.  They now recommend that the LDL and cholesterol levels are no longer important.  People with known heart disease, all Type 2 diabetics ages 40 to 75 with LDL over 190 and anyone ages 40 to 75 who has a 7.5  % or greater chance of developing heart disease in the next 10 years should by on statins, period.  This will increase the statin users by 16%.  The non-statins are not being recommended since there is no evidence that they help the heart enough to overcome the potential side effects. These people should just stay on statins and do not need to get their levels down to any definite number.          Top


Long Island College Hospital has been ordered to stop admitting patients and ambulance have been ordered to stay away from the hospital.  This is due to a lack of specialists at the institution.  The hospital has sued in the past to keep it open and will sue again in the future.  However, should it remain open?

There was an interesting article in Medscape about the hospital physician lounge.  They state that if a prospective physician goes to the hospital and sees a physician's lounge that is not active they should stay away.  The empty lounge means higher rates of physician dissatisfaction.        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.