Posts Tagged ‘fewer doctors’

Death To America, ObamaCare-Style: ObamaCare Already A Nightmare For Doctors, Soon To Be A Nightmare For Poor, Sick Patients

April 4, 2015

Remember how Barack Hussein Obama said over and over and over again that if you like your doctor, his ObamaCare would allow you to keep your doctor, and if you like your health plan, his ObamaCare would allow you to keep your health plan?

He lied.  And in the minimum of 37 times he lied on that issue alone, Barack Obama became the most documented liar in all of human history as he looked more than 300 million Americans in the eye and lied like the hell that he is again and again and again.  It was “the lie of the year,” and you’ve got to be a world-class demon-possessed liar to emerge out of all the lies that we are told in this country today.

But that was hardly this demon-possessed liar’s only lie about ObamaCare.  Obama promised his ObamaCare would help doctors, that it would help poor, sick patients, that it would bend the cost curve for healthcare down.

All lies.

Here’s an article from Saturday’s USA Today that exposes these lies (it appeared in my print edition under the title, “Maddened by metrics”):

Quality payment incentives: What’s the point?
Jordan Rau, Kaiser Health News 6 a.m. EDT April 4, 2015

Dr. Michael Kitchell initially welcomed the federal government’s new quality incentives for doctors. His medical group in Iowa has always scored better than most in the quality reports that Medicare has provided doctors in recent years, he said.

But when the government launched a new payment system that will soon apply to all physicians who accept Medicare, Kitchell’s McFarland Clinic in Ames didn’t win a bonus. In fact, there are few winners: Out of 1,010 large physician groups that the government evaluated, just 14 are getting payment increases this year, according to Medicare. Losers also are scarce. Only 11 groups will be getting reductions for low quality or high spending.

“We performed well, but not enough for the bonus,” said Kitchell, a neurologist. “My sense of disappointment here is really significant. Why even bother?”

Within three years, the Obama administration wants quality of care to be considered in allocating $9 of every $10 Medicare pays directly to providers to treat the elderly and disabled. One part of that effort is well underway: revising hospital payments based on excess readmissions, patient satisfaction and other quality measures. Expanding this approach to physicians is touchier, as many are suspicious of the government judging them and reluctant to share performance metrics that Medicare requests.

“Without having any indication that this is improving patient care, they just keep piling on additional requirements,” said Mark Donnell, an anesthesiologist in Silver City, N.M. Donnell said he only reports a third of the quality measures he is expected to. “So much of what’s done in medicine is only done to meet the requirements,” he said.

The new financial incentive for doctors, called a physician value-based payment modifier, allows the federal government to boost or lower the amount it reimburses doctors based on how they score on quality measures and how much their patients cost Medicare. How doctors rate this year will determine payments for more than 900,000 physicians by 2017.

Medicare is easing doctors into the program, applying it this year only to medical groups with at least 100 health professionals, including doctors, nurses, speech-language pathologists and occupational therapists. Next year, the program expands Medicare to groups of 10 or more health professionals. In 2017, all remaining doctors who take Medicare — along with about 360,000 other health professionals — will be included. By early in the next decade, 9% of the payments Medicare makes to doctors and other professionals would be at risk under a bill that the House of Representatives passed in March.

The quality metrics used to judge doctors vary by specialty. One test looks at how consistently doctors keep an accurate list of all the drugs patients were taking. Others track the rate of complications after cataract surgery, say, or whether patients received recommended treatments for particular cancers.

There are more than 250 quality measures. Groups and doctors must report a selection — generally nine, which they choose — or else be automatically penalized. This year, 319 large medical groups are having their reimbursements reduced by 1% because they did not meet Medicare’s reporting standards.

Physicians who do report their quality data fear the measures are sometimes misguided, usually a hassle, and may encourage doctors to avoid poorer and sicker patients, who tend to have more trouble controlling asthma or staying on antidepressants, for instance.

Leanne Chrisman-Khawam, a primary care doctor in Cleveland, said many of her patients have difficulty just getting to follow-up appointments, since they must take two or three buses. She said those battling obesity or diabetes are less likely to reform their diets to emphasize fresh foods, which are expensive and less available in poor neighborhoods. “You’re going to link that physician’s payment to that life?” she asked.

Hamilton Lempert, an emergency room doctor in Cincinnati, criticized one measure that requires him to track how often he follows up with patients with high blood pressure.

“Most everyone’s blood pressure is elevated in the emergency department because they’re anxious,” Lempert said. Another metric encourages testing the heart’s electrical impulses in patients with non-traumatic chest pain, which Lempert said has led emergency rooms to give priority to these cases over more serious ones.

“It’s just very frustrating, the things we have to do to jump through the hoops,” he said.

In the first year doctors are affected by the program, they can choose to forgo bonuses or penalties based on their performances. After that, the program is mandatory. This year, 564 groups opted out, but even if all of them had been included, only 3% would have gotten increases and 38% would have seen lower payments, mostly for not satisfactorily reporting quality measures, Medicare data show.

Smaller groups and solo practitioners are even less likely to report quality to the government. “The participation rates, even though it’s mandated, are just really low,” said Dr. Alyna Chien, an assistant professor at Harvard Medical School. It’s “a level of analytics that just is not typically built into a doctor’s office.”

Dr. Lisa Bielamowicz, chief medical officer of The Advisory Board, a consulting group, predicted more doctors will start reporting their quality scores when the prospect of fines is greater. “They are not going to motivate until it is absolutely necessary,” she said. “If you look at these small practices, a lot of them just run on a shoestring.”

This year’s assessments of big groups were based on patients seen in 2013. A total of $11 million of the $1.2 billion Medicare pays doctors is being given out as bonuses, which translates to a 5% payment increase for those 14 groups getting payment increases this year. That money came from low performers and those that did not report quality measures to Medicare’s satisfaction; they are losing up to 1%.

The exact amount any of these groups lose will depend on the number and nature of the services they provide over the year. This year, 268 medical groups were exempted because at least one of their doctors was participating in one of the government’s experiments in providing care differently.

Officials at the Centers for Medicare & Medicaid Services declined to be interviewed about the program, but said in a prepared statement that they have been providing all doctors with reports showing their quality and costs. “We hope that this information will provide meaningful and actionable information to physicians so that they may improve the coordination and integration of the health care provided to beneficiaries,” the statement said.

Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.

How the hell do you think fining doctors – who are already operating on a shoestring – for not doing something that massively increases their costs because making those reports is very obviously not something they are equipped to do, is going to lower the cost of healthcare?  Are you really that stupid that you believe it will???

Doctors are frustrated and getting more and more frustrated.  We’ve already seen them retiring at the highest rate since Hippocrates was working on his oath millennia ago.  It’s been going on since the damn evil law passed and it’s going to pick up speed.  We’re seeing fewer and fewer doctors left to service larger and larger networks of patients.  Now they are increasingly dropping out of ObamaCare and its reporting requirements as fast as they can.  How in the hell is that supposed to improve patient care?  Are you really that stupid that you believe it will???

You’ve got to love this prophetic title from CBS News that heralds future doom:

Obamacare 2015: Higher costs, higher penalties

With the Affordable Care Act to start enrollment for its second year on Nov. 15, some unpleasant surprises may be in store for some.

That’s because a number of low-priced Obamacare plans will raise their rates in 2015, making those options less affordable. On top of that, penalties for failing to secure a health-insurance plan will rise steeply next year, which could take a big bite out of some families’ pocketbooks.

“The penalty is meant to incentivize people to get coverage,” said senior analyst Laura Adams of InsuranceQuotes.com. “This year, I think a lot of people are going to be in for a shock.”

Oops.  Sorry, poor people.  It sort of looks like Obama and his demonic minions didn’t actually give a DAMN about you, after all.

But the real lie – the lie that makes “Democrat” truly stand for “DEMOn-possessed bureauCRAT” – is the one about helping the poor and the sick get better access to medical care.  Let me replay the lines from the article:

Physicians who do report their quality data fear the measures are sometimes misguided, usually a hassle, and may encourage doctors to avoid poorer and sicker patients, who tend to have more trouble controlling asthma or staying on antidepressants, for instance.

Leanne Chrisman-Khawam, a primary care doctor in Cleveland, said many of her patients have difficulty just getting to follow-up appointments, since they must take two or three buses. She said those battling obesity or diabetes are less likely to reform their diets to emphasize fresh foods, which are expensive and less available in poor neighborhoods. “You’re going to link that physician’s payment to that life?” she asked.

Barack Obama – in his wickedness – has designed a system that pits doctors against the poorest, sickest patients.  The doctor can treat them, sure, but only if he or she is willing to pay severely for it and be punished for it by an evil system that promised to do the very opposite of what it is in fact doing.

Barack Obama looks down on that doctor from his satanic Mt. Olympus and he sees a doctor whose stats aren’t up to muster because that doctor is treating sick patients who will tend to get sicker even with the very best of care.  And Obama decrees, “That doctor must be punished!”  And the fines and the penalties start kicking in.  Better to just leave that poor, sick patient on the side of the road, modern-day Good Samaritan physician.  Because Obama will come after you with all the power of totalitarian government arbitrariness if you try to help that patient.

Here’s another demonic DEMOnic bureauCRAT lie for you: Obama promised fewer people would use emergency rooms; when the very OPPOSITE is happening BECAUSE OF HIS DEMONIC LAW as USA TODAY documents:

More patients flocking to ERs under Obamacare

LOUISVILLE, Ky. — It wasn’t supposed to work this way, but since the Affordable Care Act took effect in January, Norton Hospital has seen its packed emergency room become even more crowded, with about 100 more patients a month.

That 12 percent spike in the number of patients — many of whom aren’t actually facing true emergencies — is spurring the Louisville hospital to convert a waiting room into more exam rooms.

“We’re seeing patients who probably should be seen at our (immediate-care centers),” said Lewis Perkins, the hospital’s vice president of patient care and chief nursing officer. “And we’re seeing this across the system.”

That’s just the opposite of what many people expected under Obamacare, particularly because one of the goals of health reform was to reduce pressure on emergency rooms by expanding Medicaid and giving poor people better access to primary care.

Instead, many hospitals in Kentucky and across the nation are seeing a surge of those newly insured Medicaid patients walking into emergency rooms.

Nationally, nearly half of ER doctors responding to a recent poll by the American College of Emergency Physicians said they’ve seen more visits since Jan. 1, and nearly nine in 10 expect those visits to rise in the next three years. Mike Rust, president of the Kentucky Hospital Association, said members statewide describe the same trend.

Experts cite many reasons: A long-standing shortage of primary-care doctors leaves too few to handle all the newly insured patients. Some doctors won’t accept Medicaid. And poor people often can’t take time from work when most primary care offices are open, while ERs operate round-the-clock and by law must at least stabilize patients. […]

The same “experts” who didn’t see what we conservatives were predicting EVER SINCE THIS DEMONIC LAW THREATENED AMERICA TO BEGIN WITH are refusing the see the REAL cause: the law was based entirely on lies because the Democrats who shoved this evil monstrosity down our collectivist throats are demon-possessed liars.

Not one month ago, I wrote up my own experience with the Veterans Administration as to how this very arbitrary bureaucratic mindset is just taking over the entire system.  Within the span of one week, I suffered that arbitrariness of penalizing decent people because of the behavior of others TWICE.  First, I was contacted and ORDERED to take a urine test.  Why?  I wanted to know; I’d just taken one and that test had nothing to do with my healthcare.  Rather, it had been a drug test because I’m on oxycodone for the pain created by my service-connected medical condition.

Well, less than three months after the last test – which proved I was completely clean of anything but what I was supposed to be taking – I was being commanded to take it again.  And apparently under Obama I will have to be treated like a drug criminal at least four times a year from now on.

Why?  Because other veterans somewhere else are abusing their prescription drugs.  So the obvious thing to do – as obvious as it is to treat a 103-year-old Catholic nun in a walker like a young Middle Eastern terrorist male – is to treat EVERYONE like a criminal or an addict.

I have been receiving physical therapy for a major shoulder surgery.  I was given a month-and-a-half worth of appointments and I kept every single one of them.  In fact, I have NEVER missed an appointment with the VA.  But because somebody somewhere had missed appointments, the “system” decided to treat EVERYONE like a no-shower.

So I know firsthand exactly what these doctors are saying: it doesn’t matter if I do right or not; the system will punish me anyway.  And it will do so by protecting the very worst people (who of course vote Democrat, don’t they?) by redistributing the pain for the cost of their godawful behavior onto everyone else.  That’s what the welfare system is based on, baby: “Oh, you don’t have a job because you refuse to get off your fat, pimply ass and look for one and it’s easier to pump out ten kids and collect increased payments for each one?  Don’t worry, dearie, here’s the money somebody else earned by working his butt off.  Please don’t forget to vote for Messiah Obama unless you want mean Republicans to force you to produce something with your life besides flatulence!”

I’ve talked to several veterans who are as livid as I am.  And they are saying they’re just going to start buying the marijuana that the same damn DEMOnic bureauCRATS who are forcing them to take the piss tests for drugs are opening up for everybody else so they can be happier welfare recipients.  And why bother busting your ass to show up for appointments when you’re going to be treated like dirt whether you show up or not???

And so they are producing the very opposite thing to what they are stupidly claiming they are producing.

What Obama is producing is the same thing the ayatollahs Obama is appeasing and negotiating with are calling for: “Death to America!”

The fact of the matter is that ObamaCare was sold and marketed entirely on the basis of lies.  That is just a documented fact.

But the even sadder fact of the matter is that unless the Supreme Court finally steps in and does the right thing and overturns this fascist takeover of the American healthcare system, ObamaCare will destroy America because nothing will be able to prevent it from doing so.  It was crafted as a metastasizing cancer that will keep becoming larger and making the patient America sicker until that patient collapses and dies.

 

ObamaCare Driving Essential Primary Care Physicans Out Of Medicine

April 25, 2010

Does this sound good to you?

Sign Of Times Under ObamaCare: ‘The Doctor Is Out — Permanently’
By SALLY C. PIPES Posted 06:51 PM ET

President Barack Obama’s health care bill aims to achieve universal coverage while at the same time reducing costs. In reality, this contradictory strategy will ensure that Americans enjoy less health care, of poorer quality, and from fewer doctors.

And while the full effects of ObamaCare might not be felt until Tax Day 2014, the promise of free health care to millions of Americans will begin to prove hollow long before then.

Already Rep. Henry Waxman, D-Calif., says the public option might not be dead if insurance companies do not offer competitive rates within the exchanges. And Sen. Tom Harkin, D-Iowa, has revived a proposal that gives the secretary of health and human services the power to review premiums and block any rate increase bound to be “unreasonable.”

America’s primary care system is already under stress. Low reimbursement rates, bureaucratic paperwork and long hours are driving family physicians out of medicine and pushing new doctors into specialized practices. Half a century ago, one in two doctors practiced general medicine. Today, 7 in 10 specialize.

And the gap is growing. A mere 1 in 12 medical-school graduates now head to family medicine. In 2009, the American Academy of Family Physicians warned that we’d be short 40,000 family doctors in a decade, if present trends continued. Today, medical schools produce one primary care doctor for every two who are needed.

ObamaCare will add strain to an already burdened system. The new bill seeks to increase the load on family doctors while holding the line on costs by putting price controls on government insurance plans. In due course, price controls on private plans will be inevitable.

We saw them come into effect on April 1 in Massachusetts, when the state Division of Insurance rejected 235 of 274 premium increases proposed by insurers for individuals and small businesses. The rate increases — ranging from 8% to 32% — were deemed excessive.

The combination of increased coverage and emphasis on primary care, experts say, will increase demand for primary care docs by as much as 29%, or 44,000 doctors, over the next 15 years.

But just as demand is increasing, doctors are making plans to exit. A 2009 survey by medical recruiters Merritt Hawkins found that 10% of respondents were planning to leave medicine within three years.

Another poll of physicians conducted in 2009 by Investor’s Business Daily found that 45% of doctors would consider early retirement if ObamaCare passed.

Obama and the Democrats lied about their ObamaCare boondoggle reducing the costs of healthcare.  It RAISES the cost of healthcare by $311 billion when the last thing we need is more out-of-control government spending.

We also find that basically one out of every six hospitals (fifteen percent) are probably going to close under ObamaCare as they get nickeled and dimed right out of business.

Then you add the fact that doctors are saying that they are going to leave medicine in droves as they similarly get nickeled and dimed and regulated out of medicine.

So we’re talking about adding millions of new patients (including illegal immigrants, almost certainly), while dramatically reducing the number of doctors and hospitals who would treat those patients.

If I wanted to crash the American health care system, that’s pretty much how I’d do it.

Breast Cancer Screening: Government Fires First Volley Of Rationing, Death By Medical Neglect

November 19, 2009

Let me begin by saying that the current versions of ObamaCare don’t have a single death panel.

It’s more like 111 separate death panels.

Some of the names  and acronyms of the dozens and dozens of bureaucracies are undoubtedly different under the new iteration of socialized medicine, but here’s a snapshot of your new health care system if Democrats get their way:

The Senate version is 2,075 pages of fun, I hear.  Nobody understands it.  And nobody is going to end up getting a chance to read it by the time it gets voted on.

If you thought that there was going to be any kind of transparency or accountability – or even honesty – from the Obama administration – you need to stop smoking your crack pipe.

This latest event in the march toward socialized medicine reminds me of the case of Barbara Wagner.  In Oregon, which has “universal coverage” through the state, she was abandoned to die by a system that would not pay for her cancer treatment, but offered to pay for her euthanasia.

Only this time, the government wants to deny treatment on the other side of the cancer diagnosis.

IBD Editorials

Rationing’s First Step

Health Care: A government task force has decided that women need fewer mammograms and later in life. Shouldn’t that be between patient and physician? We have seen the future of health care, and it doesn’t work.

We have warned repeatedly that the net results of health care bills before Congress will be higher demand, fewer doctors, more cost control, all leading to rationing.  New recommendations issued by the U.S. Preventive Services Task Force (USPSTF) regarding breast cancer and the necessity for early and frequent mammograms do not convince us otherwise.

Just six months ago, the panel, which works under the Health and Human Services Department as a “best practices” study group, was shouting its concern about a Centers for Disease Control and Prevention study showing a 1% drop in the number of women regularly undergoing such screening and prevention.

The task force was saying that women older than 40 should get a mammogram every one to two years. It found that frequent screening lowered death rates from breast cancer mostly for women ages 50 to 69. But that was then, and this is now.

“We’re not saying women shouldn’t get screened. Screening does save lives,” Diana Petiti, task force vice chairman, said of the recommendations published Tuesday in Annals of Internal Medicine. “But we are recommending against routine screening.”

Now the panel recommends that women in their 40s stop having routine annual mammograms and that older women should cut back to every two years. The concern allegedly is that too frequent testing can result in increased anxiety, false positives, unneeded follow-up tests and possibly disfiguring biopsies.  Preventing breast cancer and saving lives almost get lost in the new analysis.

“I have a particular concern in this case about who was involved in this task force,” says Rep. Charles Boustany, R-La., who was a heart surgeon in private life. “There are no surgeons or oncologists who deal directly with breast cancer or even radiologists. … I’ve seen far too many young women develop late-stage breast cancer because they didn’t have adequate screening.”

Little, if anything, has happened medically in the last six months to cause such a shift. A lot, however, has happened politically as a health care overhaul has limped forward on life support. The Congressional Budget Office has been busy pricing these various bills, a process that includes screening and prevention.

As we have warned, the growing emphasis seems to be on cost containment rather than quality of care. About 39 million women undergo mammograms each year in America, costing the health care system more than $5 billion.

“The American Cancer Society continues to recommend annual screening using mammography and clinical breast examination for all women beginning at age 40,” says Otis Brawley, its chief medical officer. “Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider.”

Daniel Kopans, a radiology professor at Harvard Medical School, says: “Tens of thousands of lives are being saved by mammography screening, and those idiots want to do away with it. It’s crazy — unethical, really.”

This, sadly, appears to be the future of medicine under government-run health care. Aside from taxes on insurers, providers and device manufacturers, we’ll be up to our eyeballs in cost-effectiveness boards that will decide who gets what tests and treatments, when and if. These are only recommendations for now, but they are the shape of things to come.

An IBD/TIPP poll found that 45% of medical doctors would consider retiring if the Congressional health care “reform” passes.  Given the fact that an increasing shortage of doctors is already one of the chief burdens in providing health care, this exodus would amount to a catastrophe that our health system would never recover from.

In Canada, the chronic doctor shortage has been bad enough that patients literally have to sign up for a lottery in order to have a chance to “win” a primary care physician.  But now we are learning that overwhelmed Canadian doctors are using a lottery of their own to dump patients.

Why on earth would anyone want this for America?

The Obama administration is preparing the health delivery system to implement the philosophy of Obama advisers such as Robert Reich, Ezekiel Emanuel, and Cass Sunstein, which can be easily summarized with the quote:

It’s too expensive…so we’re going to let you die.”

Robert Reich’s words in context only make the hateful idea sound even more hateful:

And by the way, we’re going to have to, if you’re very old, we’re not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It’s too expensive…so we’re going to let you die.”

Then there are the words of Obama’s Regulatory Czar, Cass Sunstein, who wrote:

“I urge that the government should indeed focus on life-years rather than lives. A program that saves young people produces more welfare than one that saves old people.”

And Rahm Emanuel’s brother Ezekiel, whom Obama appointed as his OMB health policy adviser in addition to selecting him to serve on the Federal Council on Comparative Effectiveness Research wrote:

“When implemented, the Complete Lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuatedThe Complete Lives system justifies preference to younger people because of priority to the worst-off rather than instrumental value.”

“Attenuated” means, “to make thin; to weaken or reduce in force, intensity, effect, quantity, or value.”  Attenuated care would be reduced or lessened care.  Dare I say it, in this context it clearly means, “rationed care.”

And Obama himself told a woman who wanted to keep her aging mother alive:

“At least we can let doctors know — and your mom know — that you know what, maybe this isn’t going to help. Maybe you’re better off, uhh, not having the surgery, but, uhh, taking the painkiller.”

YOU take the painkiller rather than have that lifesaving surgery, Barry Hussein.  And why don’t you insist that Michelle and your two daughters take the pill rather than have that lifesaving surgery, too?  Just to be like all the “little people” out there.

But of course that’s not going to happen.  Rather, Democrats have now exempted themselves from 11 separate amendments that would have required them to have the same ObamaCare that they want to force everyone else to have.

You can understand why they would do so, given the promises that the system will be worse than terrible, and due to the fact that even a complete idiot who looks around and sees how horribly the administration has managed the H1N1 vaccine situation can recognize that taking on 1/6th of the economy would be beyond catastrophic.  I mean, heck, if I were a Democrat, I’d be sure to exempt myself from this monstrosity too, lest MY family members fall under the coming steamroller.

This “recommendation” of reducing mammographies isn’t mandatory now, but that’s because the government hasn’t usurped the health care system yet.  You just wait a decade from now, when the government runs everything, and soaring deficits force them to start cutting costs.


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