Impeding changes to our Health Care system

[piercehawkeye45]

Originally Posted by classicman

Is this a national, regional or local trend?

Seems to be national or at least spread in pockets around the country.

Dr. Keith Jantz, an internist at Kansas City Internal Medicine, fears that if the 21% cut goes through next year, "physicians around the country would stop seeing any Medicare patients."

"It's happening in places like Las Vegas and in Anchorage, Alaska, and this could be a harbinger of what's to come unless Medicare maintains decent [payment] rates," Jantz said.

But....

The federal government's Center for Medicare and Medicaid Services (CMS) said it is aware of anecdotal reports of doctors not taking Medicare beneficiaries.

However, the agency maintains that its own data, and other industry reports, show only a small percentage of beneficiaries unable to get physician access.

CMS said 96.5% of all practicing physicians, nearly 600,000 doctors, currently participate in Medicare.

"Geographically, the level within every state is less than 5% of Medicare beneficiaries who have difficulties accessing a doctor," said Renee Mentnech, director of CMS' Research and Evaluation Group.

Mentnech also pointed to an August report from the Government Accountability Office (GAO), an independent branch of the Congress, that showed less than 3% of Medicare beneficiaries reported major difficulties accessing physician services in 2007 and 2008.

http://money.cnn.com/2009/10/27/news...ion=2009110100

[classicman]

I think those numbers are mileading (yeh me questioning the gov't) The issue is more of how many are accepting NEW patients not just those who participate.

Now that I think about it, I wonder what the gov't definition of "participate" is.

This part of that article is

Dr. John Hagan, a Kansas City-area ophthalmologist, offers a unique perspective. "I can speak to both sides of this," he said.

As many as 75% of patients at his group practice are Medicare beneficiaries who are treated for problems such as glaucoma or undergo cataract surgery. And if payment rates are cut 21%, after already being reduced to about half the going $1,200 rate for cataract surgery and care in Missouri, Hagan said he won't be able to see more Medicare patients because he won't be able to cover his expenses.

But Hagan himself became Medicare-eligible this month -- and he's nervous. "If I accept Medicare for myself and my wife, I'm fearful I won't be able to stay with my cardiologist and my wife won't be able to stay with her physicians," he said.

Hagan has elected not to enroll in Medicare. Instead, he's paying extra out of pocket for his company's insurance coverage.

"At some point I won't want to work," said Hagan. "At that time, I will be on Medicare, and I am scared to death."

**bold mine**

[piercehawkeye45]

Originally Posted by classicman

I think those numbers are mileading (yeh me questioning the gov't) The issue is more of how many are accepting NEW patients not just those who participate.

I'm guessing most numbers will be misleading. The government, assuming it is somewhat political, will want to make it seem like a less of a problem while the AARP, and similar groups, will want to exaggerate the data.

But yes, Medicare is going to be a large problem. From almost every article I've read, treating Medicare patients a lot of times results in zero profit. Many doctors are accepting this zero profit because they morally are not going to drop existing patients. Others are dropping patients or at least not accepting new ones. But yet, I don't know if that zero or negative profit are exceptions or across the board.

[Undertoad]

IOW, TX docs are dropping out of Medicare at a rate of 0.3% per year. Alarmed?

[classicman]

If 0.3% per year is an accurate number - no not really. But those are only the ones that are dropping completely out. The question I was trying to raise is how many are NOT accepting NEW patients. I think thats a totally different number. Some/most will continue to care for their current patients, but not accept any new ones.
I dunno if its an issue. I have had quite a bit of trouble finding one in my area that is accepting new patients. Many say the accept medicare/caid, but when you call they aren't accepting new patients.

[Clodfobble]

One of our primary care physicians has a sign up at the front desk that specifically says if/when the 21% cut goes into effect, they will no longer accept any (not just new) Medicaid. But then again, several of our doctors don't take any insurance at all, so we're in a biased group. It does seem to me that if a doctor is good enough to have any loyalty from patients whatsoever, then they won't need any Medicaid patients to keep their practice running. I honestly think Congress has expected for years that Medicare and most of the recent healthcare reforms are going to implode, and they're using this as the stepping stone to gain real support for a single-payer system.

[TheMercenary]

OPINIONMAY 18, 2010.No, You Can't Keep Your Health Plan
Insurers and doctors are already consolidating their businesses in the wake of ObamaCare's passage.

By SCOTT GOTTLIEB
President Obama guaranteed Americans that after health reform became law they could keep their insurance plans and their doctors. It's clear that this promise cannot be kept. Insurers and physicians are already reshaping their businesses as a result of Mr. Obama's plan.

The health-reform law caps how much insurers can spend on expenses and take for profits. Starting next year, health plans will have a regulated "floor" on their medical-loss ratios, which is the amount of revenue they spend on medical claims. Insurers can only spend 20% of their premiums on running their plans if they offer policies directly to consumers or to small employers. The spending cap is 15% for policies sold to large employers.

This regulation is going to have its biggest impact on insurance sold directly to consumers—what's referred to as the "individual market." These policies cost more to market. They also have higher medical costs, owing partly to selection by less healthy consumers.

Finally, individual policies have high start-up costs. If insurers cannot spend more of their revenue getting plans on track, fewer new policies will be offered.

http://online.wsj.com/article/SB1000...p_mostpop_read

[TheMercenary]

Clod, one of the places I work at has done the same, as well as sent out letters to all the Medicaid patients.

I agree, it is nothing more than a move to a single payer system.

[TheMercenary]

Well imagine this. Just as was stated repeatedly....

Keep Your Health Plan Under Overhaul? Probably Not, Gov't Analysis Concludes

Internal administration documents reveal that up to 51% of employers may have to relinquish their current health care coverage because of ObamaCare.

Small firms will be even likelier to lose existing plans.

The "midrange estimate is that 66% of small employer plans and 45% of large employer plans will relinquish their grandfathered status by the end of 2013," according to the document.

http://www.investors.com/NewsAndAnal...aspx?id=537208

If you don't like that link here is another:

http://www.breitbart.com/article.php...show_article=1

Originally Posted by TheMercenary

Well imagine this. Just as was stated repeatedly....

Keep Your Health Plan Under Overhaul? Probably Not, Gov't Analysis Concludes




http://www.investors.com/NewsAndAnal...aspx?id=537208

If you don't like that link here is another:

http://www.breitbart.com/article.php...show_article=1

Two partisan opinions.

Here is one that presents both sides.

Business groups gave mixed reviews this week to new Obama administration rules limiting how much employers and insurers can change their health insurance plans while remaining exempt from potentially costly new consumer protections.

Consumer groups praised the regulations, saying the rules would ensure that millions of Americans receive the full benefits of the new health care law....

...The rules, released Monday, spell out when plans would lose their grandfathered status, including if they make major increases in premiums, modest increases in co-payments or significantly cut benefits. The administration estimates that half of all employers, including two-thirds of small employers, could lose their grandfathered status by 2013.

Read more: http://www.miamiherald.com/2010/06/1...#ixzz0qxdGw1UQ

So....employers with plans that would allow major increases in premiums or co-pays or benefit cuts wont be grand-fathered and will change.

Sounds good to me.

[TheMercenary]

Say it isn't so!?!? Low wage earners are about to get the shaft.

Health law could ban low-cost plans

Part of the health care overhaul due to kick in this September could strip more than 1 million people of their insurance coverage, violating a key goal of President Barack Obama’s reforms.


Under the provision, insurance companies will no longer be able to apply broad annual caps on the amount of money they pay out on health policies. Employer groups say the ban could essentially wipe out a niche insurance market that many part-time workers and retail and restaurant employees have come to rely on.

This market’s limited-benefit plans, also called mini-med plans, are priced low because they can, among other things, restrict the number of covered doctor visits or impose a maximum on insurance payouts in a year. The plans are commonly offered by retail or restaurant companies to low-wage workers who cannot afford more expensive, comprehensive coverage.


Depending on how strictly the administration implements the provision, the ban could in effect outlaw the plans or make them so restrictive that insurance companies would raise rates to the point they become unaffordable.

http://www.politico.com/news/stories/0610/38219.html

[TheMercenary]

Bottom line this administration and the Demoncrats lied to the US taxpayers about how much this is going to really cost us in dollars and how much it is going to affect our current insurance. Just as I predicted, numerous time.

[classicman]

Originally Posted by TheMercenary

Bottom line this administration and the Demoncrats lied to the US taxpayers about how much this is going to really cost us in dollars and how much it is going to affect our current insurance. Just as I predicted, numerous time.

We all knew that those with health insurance would have their plan rates increased or lose benefits. It was a given.

Originally Posted by classicman

We all knew that those with health insurance would have their plan rates increased or lose benefits. It was a given.

Or getting new benefits like free (no co-pay) preventive care, including mammograms and colonoscopy, no more exclusions for pre-existing conditions, limits on out-of-pocket expenses so you wont go bankrupt as a result of an illness/medical condition, a tougher dispute resolution process so insurers cant drop you on a whim, limits on premium increases (as percent of insurers admin costs)....

[classicman]

http://www.investors.com/NewsAndAnal...aspx?id=537208

Sorry, but I am certainly not opening that one!