Posts Tagged ‘New England Journal of Medicine’

ObamaCare Factoid: Access To Health Care Doesn’t Mean Squat When Hospitals, Doctors And Pharmacists Bail

March 22, 2010

As an introduction, let me just say this: In this article, I detail that doctors and hospitals and pharmacies are going to bail out of Medicare and Medicaid – if they don’t just go out of business altogether.  They aren’t bailing out on private insurers – the free market businesses that Obama and the Democrats have continuously demonized and demagogued – they’re bailing out on the very government health care systems that liberals want to erect in the place of the free market health care system that they are destroying.  And as a matter of fact, the poorest and neediest are the ones who will likely suffer the most due to this terrible ObamaCare bill.

Congratulations, Democrats.  Thanks to the passage of ObamaCare, you and all your useless slacker friends who love to parasitically leach off of society will have access to health care.

Mind you, that “access” won’t mean squat as doctors, pharmacies, etc. stop accepting patients from Obama and his crappy government.

Don’t believe me?  Well, here’s some info from the New York Times:

EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn’t know any — and that if Ms. Plumb found one she liked, could she call and tell her the name?

Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists  and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.

When shopping for a doctor, ask if he or she is enrolled with Medicare. If the answer is no, that doctor has opted out of the system. Those who are enrolled fall into two categories, participating and nonparticipating. The latter receive a lower reimbursement from Medicare, and the patient has to pick up more of the bill.

Doctors who have opted out of Medicare can charge whatever they want, but they cannot bill Medicare for reimbursement, nor may their patients. Medigap, or supplemental insurance, policies usually do not provide coverage when Medicare doesn’t, so the entire bill is the patient’s responsibility.

The solution to this problem is to find doctors who accept Medicare insurance — and to do it well before reaching age 65. But that is not always easy, especially if you are looking for an internist, a primary care doctor who deals with adults. Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.

Two trends are converging: there is a shortage of internists nationally — the American College of Physicians, the organization for internists, estimates that by 2025 there will be 35,000 to 45,000 fewer than the population needs — and internists are increasingly unwilling to accept new Medicare patients.

Sorry to throw you out on your ass, old timer.  But the government health care system sucks, and Zero is going to make it even suckier.

And here’s how Zero will make it suckier:

Updated January 14, 2010
Why Doctors Are Abandoning Medicare
By C.L. Gray, M.D.
FOXNews.com

Physicians will not be bullied into bankruptcy. Our system needs reform, but what’s being hammered out in Washington is not the answer.

Two weeks ago the Mayo Clinic shocked the nation when it closed the doors of one of its Arizona clinics to patients on Medicare. Just this past June President Obama himself praised Mayo as a model of medical efficiency noting that Mayo gives “the highest quality care at costs well below the national norm.” If Mayo feels compelled to walk away from this government-run program, others will surely follow. The nation must understand why.

Doctors are leaving Medicare for two reasons: one obvious, the other more concealed.

The first is simple—the math
:

1) For the past decade Medicare consistently paid physicians 20% less than traditional insurance companies for identical service.

2) On January 1, 2010 Washington made hidden cuts to Medicare by altering its billing codes.

3) Medicare will cut physician reimbursement by another 21% on March 1. The CBO said this cut must take place if the Senate healthcare bill was to “reduced the deficit.”

4) Even more, Congress pledged to cut Medicare by yet another $500 billion. Again, the CBO said this additional cut must take place if the Senate healthcare bill was to “reduced the deficit.”
Many physicians were operating at a loss even before this series of massive cuts. In 2008, Mayo Clinic posted an $840 million loss in caring for Medicare patients. No businesses can survive when patient care expenses exceed revenue.

The second is more ominous—Washington’s increasingly abusive posture toward physicians.

President Obama reflected this attitude last summer. On national television, he stated as fact a surgeon is paid between $30,000 and $50,000 for amputating a patient’s foot.

In reality, a surgeon is paid between $740 and $1,140 to perform this unfortunate, but often life-saving procedure. This reimbursement must cover a pre-operative evaluation the day of surgery, the surgery, and follow-up for 90 days after surgery—not to mention malpractice insurance, salaries for clinic nurses, and clinic overhead. It is frightening to think our president is so wildly misinformed even as he stands on the cusp of overhauling American health care. But it gets worse.

Given massive federal deficits, Washington now faces increasing pressure to cut Medicare spending. One way to do this is to intimidate physicians into under-billing. To do this Washington intends to spend tax payer dollars to ramp up physician audits using Recovery Audit Contractors (RAC audits) to randomly investigate private physician’s Medicare billing.

A physician group at my hospital recently experienced an AdvanceMed audit, an earlier version of the RAC. For a year Medicare auditors made their practice a living hell, making them question if it was worth caring for Medicare patients at all. [click to keep reading]

Do you remember that bit about the Mayo Clinic no longer accepting Medicare patients in Arizona?  That’s a trend the rest of the country is going to follow.  From the Wall Street Journal:

President Obama last year praised the Mayo Clinic as a “classic example” of how a health-care provider can offer “better outcomes” at lower cost. Then what should Americans think about the famous Minnesota medical center’s decision to take fewer Medicare patients?

Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.

Mayo says it lost $840 million last year treating Medicare patients, the result of the program’s low reimbursement rates. Its hospital and four clinics in Arizona—including the Glendale facility—lost $120 million. Providers like Mayo swallow some of these Medicare losses, while also shifting the cost by charging more to private patients and insurers.

Sorry, senior.  But you can’t get your prescriptions refilled, either.  From the Seattle Times:

Walgreens will stop taking new Medicaid patients in Washington state as of April 16, saying it loses money filling their prescriptions.

Effective April 16, Walgreens drugstores across the state won’t take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition — the latest development in an ongoing dispute over Medicaid reimbursement.

Now that ObamaCare has passed, get ready to see more and more doctors say bye-bye:

If ObamaCare passes, you may lose your family doctor.  Oh, and good luck finding a new one.

That’s the stunning conclusion of a new study by the Medicus Firm, as reported by Recruiting Physicians Today, a newletter published by the publishers of the New England Journal of Medicine.  Medicus, a national physician search firm, surveyed 1,195 practicing physicians about the health reform plans pending in Congress.  The doctors, representing a wide range of specialties and career levels, were asked to assess the possible impact of ObamaCare on their careers, including “income, job satisfaction, and future career plans.”1

The bottom line of that investigation, titled Physician Survey: Health Reform’s Impact on Physician Supply and Quality of Medical Care, is summed up by Medicus managing partner Steve Marsh:  “What many people may not realize is that health reform could impact physician supply in such a way that the quality of health care could suffer.  The reality is that there may not be enough doctors to provide quality medical care to the millions of newly insured patients.”2

Why?  Put simply, doctors fear that ObamaCare would make the business and practice of medicine more trouble than it’s worth.  The surveyed physicians foresee in their future under ObamaCare a decrease in income coupled with an increased work load, a toxic combination of new regulations and taxes plus millions of newly insured individuals swelling their patient rosters.

The doctors assessed the possible impact of several iterations of ObamaCare.  For example, 72 percent felt their income would decrease under a health reform bill that included a public option, while 50 percent predicted a decrease in income under a health reform regime without a public option.

Not surprisingly, “an overwhelming 63 percent of physicians prefer a more gradual, targeted approach to health reform” as opposed to the massive, one-size fits all plans favored by the President and Congressional leaders.3 An astonishing 46 percent of responding primary care physicians claim they would leave or try to leave medicine as a result of ObamaCare, gravely exacerbating the existing shortage of primary care doctors (according to the American Academy of Family Physicians, the number of U.S. medical school students choosing primary care has already dropped 52 percent since 1997).4

The Medicus results echo a similar Investors Business Daily poll of over 1,000 practicing physicians, 65 percent of whom expressed opposition to the President’s health reform plan, and 72 percent of whom doubted the administration’s claim that the government could significantly expand coverage and provide better care at lower costThe IBD poll, conducted in September of 2009, also found a startling number of physicians, 45 percent, who would consider quitting if ObamaCare becomes law.  The grim conclusion of the IBD survey:  “Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted.”5

If ObamaCare would drive practicing doctors out of work, it would also devastate efforts to recruit new physicians.  After all, how do you persuade talented young people to enter a business that promises high taxes, regulation, risk and stress – without commensurate compensation? For the average health care consumer, the result of this shrinking pool of physicians would be long waits and rationed care, to say nothing of overworked, unhappy doctors.

A CNN Money article details that children and the poorest and most vulnerable adults are going to increasingly suffer as doctors bail out of Medicaid.

There’s another inherent rub there.  Democrats pitched ObamaCare as taking care of “47 million Americans” who can’t afford insurance.  But the poor always had access to coverage under Medicaid.  The only reason many of these people don’t use Medicaid is because the government program is such a total disaster, or they can’t find a doctor who will lose money treating them.

I’ll quote myself from an earlier article to make a couple more points about the “47 million Americans” lie:

If you believe that the government is going to create a trillion dollar entitlement that ensures 47 million more people – (John Larson, chairman of the Democratic caucus, used the “47 million” figure on ABCs “This Week” just yesterday; he used it again on CNNs “State of the Union”) and spends less money than is spent now, you are an abject fool.

And that “47 million” clearly includes 17 million illegal immigrants.  The Democrats’ incredibly cynical plan is to take health resources from you and from your children and grandchildren and give those resources to illegal immigrants so they can capture the Hispanic vote.

The bottom line about ObamaCare is that it is a government program, in which the government demonizes and destroys the private system of insurers and doctors and hospitals and pharmacists that make the system work, and offer in its place an utter disaster.

This ObamaCare boondoggle is going to be a holocaust.  God only knows how many people – especially the poorest and most vulnerable – are going to die.  It’s going to be legalized murder.

They say the road to hell is paved with good intentions.  I don’t think the Democrats’ intentions are all that good, but I do know that this is a road – scratch that, a superhighway – to hell.

38 States Now Working To Preempt ObamaCare Disaster

March 18, 2010

Rasmussen as of March 15 found that:

A new Rasmussen Reports national telephone survey finds that 43% favor the health care plan proposed by President Obama and congressional Democrats, while 53% oppose it. Those findings include 23% who Strongly Favor the plan and 46% who Strongly Oppose it.

The numbers are virtually unchanged from last week and are consistent with findings in regularly tracking going back to just after Thanksgiving.

Democrats continue to overwhelmingly support the plan, while Republicans and voters not affiliated with either party strongly oppose it.

Opposition continues to stem in part from unchanging views that the plan will drive up the cost and worsen the quality of health care in America. Fifty-seven percent (57%) of voters also believe the health care reform plan now working its way through Congress will hurt the U.S. economy.

But Barack Obama and the Democrats are tyrants, not leaders.  They want to rule, not govern.  They want to impose a system that will result in a European socialist-style government until our country implodes from massive and unsustainable deficits and debts.

Thirty-eight states (that’s 76% of the states in this country) are already at work on legislation that will preempt ObamaCare from destroying their economy and their way of life.

If this Jason Voorhees monstrosity passes, it will be the beginning.  The Republicans and the states will fight this for YEARS to come.  Nothing else will get done, and this country will drift, as we fight an evil that should never have been imposed on a people who overwhelmingly do not want it.

From the Washington Post:

BOISE, Idaho — Idaho is leading the charge in a states-rights push to defeat a proposal in Congress that would require people to buy health insurance, a key piece of reforms being pushed by President Barack Obama.

Republican Gov. C.L. “Butch” Otter used a ceremony Wednesday afternoon to become the first governor to sign into law a measure requiring the state attorney general to sue the federal government over any such insurance mandates.

There’s similar legislation pending in 37 other states, a point Otter stressed when asked if the bill he signed can succeed, given constitutional law experts are already saying federal laws would supersede those of states in a U.S. District Court fight.

“The ivory tower folks will tell you, ‘No, they’re not going anywhere,’” he told reporters. “But I’ll tell you what, you get 36 states, that’s a critical mass. That’s a constitutional mass.”

The state measures working their ways through statehouses from Missouri to South Carolina reflect a growing frustration with President Obama’s health care overhaul, especially in Republican-dominated regions.

It most certainly is not just “Republican-dominated regions.”  Here’s a list of the states that have filed measures to protect their citizens:

According to the National Conference of State Legislatures, formal resolutions or bills have been filed in opposition to the individual mandate in Alabama, Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Washington, West Virginia, Wisconsin and Wyoming.

And here’s the Obama/Democrat steamroller that the states are trying to protect their residents and their economy:

At least 36 state legislatures are considering legislation that would allow citizens to opt out of a key component of President Obama’s health-care “reform” – an “individual mandate” requiring that all Americans have health insurance.

Both the House and Senate health-care bills require Americans to purchase health insurance or pay a penalty. The House bill establishes a fine based on percentage of a person’s income, while the Senate version creates a penalty as a flat fee or percentage of income, whichever is higher. Those refusing to get insurance could be found guilty of a misdemeanor crime, punishable by another fine or even jail time.

The reason for the different numbers of states (36, 37, 38) is that they keep growing.

The Fuhrer wants to confiscate your property to pay for his boondoggle.  And if you don’t pay you’ll end up in jail.

For every one family receiving a subsidy to pay for ObamaCare, three families earning less than $200,000 a year will be forced to pay more for their health care. And at least a quarter of Americans will see their taxes RISE as a result of ObamaCare.

We are looking at a disaster of such colossal proportions it is simply stunning.  One staggering fact should put that disaster into perspective.  In a study published in the New England Journal of Medicine, Medicus discovered this grim reality:

What if nearly HALF of all physicians in America suddenly stopped practicing medicine? Such a drastic decrease in the physician workforce could become a reality, depending upon how the healthcare reform legislation is implemented, and which version of health reform passes into law.

In a physician survey conducted December 2009 by The Medicus Firm, a national physician search firm, 24.7% of physicians stated that they would “retire early” if a public option is implemented, and an additional 21.0% of respondents stated that they would quit practicing medicine, even though they are nowhere near retirement.   This brings the amount of physicians who would leave medicine to a total of 45.7%.

And of course, even as Obama talks about how “deficit neutral” his plan will be, the reality is anything but.  It’s going to massively increases taxes, and it will slash half a trillion dollars out of Medicare – a system already on the verge of collapse as it is.  And it will push all kinds of costs onto the states in the form of higher Medicaid costs that will increase by billions – and become progressively worse as the federal government increasingly decreases its reimbursement share to the states.

Democrats cite the CBO number – “only” $940 billion over 10 years (which is achieved primarily by taxing for ten years, but only paying out benefits for six years) – but consider that the CBO has something dramatically less than stunning accuracy in making such projections. As one example, they’ve been off by as much as 113% in estimating the costs of Medicare programs.

Going back to our most significant and most directly applicable program to ObamaCare – Medicare – the government underestimated the costs by a whopping factor of 10.

We are looking at fiscal implosion as it is.  Just imagine if all the hundreds of assumptions fall apart and the costs of ObamaCare begins to soar as many believe it inevitably will.

From the Cato Instutue:

When we correct for both gimmicks, counting both on- and off-budget costs over the first 10 years of implementation, the total cost of ObamaCare reaches — I’m so sorry about this — $6.25 trillion.  That’s not a precise estimate.  It’s just far closer to the truth than President Obama and congressional Democrats want the debate to be.

Are you willing to bet your life, your families’ lives, and the life of your nation on ObamaCare?

At least 38 states aren’t.

38 divided by 50 = .76.

It appears that the Spirit of ’76 has finally been resurrected as a response to tyranny.


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