Impeding changes to our Health Care system

[classicman]

Not in my book. The R's fought long and hard for what they thought was better than the Single payer/Universal the D's wanted.
IMO, both parties have to tel me why this is the best for America.
"Because thats all we could get." is not an acceptable answer for me.

[TheMercenary]

Originally Posted by classicman

Not in my book. The R's fought long and hard for what they thought was better than the Single payer/Universal the D's wanted.
IMO, both parties have to tel me why this is the best for America.
"Because thats all we could get." is not an acceptable answer for me.

The Repblickins made a half-assed attempt to be involved even though they were completely shut out of the final move to get a Bill to Congress. They really had little to do with it other than to bitch about it. Not that they did not have a right to bitch, and even those mod R's complained that the D's failed to follow through with an open amendment process after the fact, as Ms Snow was told (according to her anyway).

[classicman]

That is a matter of perspective. I'm not interested in hearing that anymore.
The D's will say that the R's just said "NO". . .
The R's say they were shut out. . .

I don't give a shit. These are the men and women that are supposed to LEAD our country. Figure it the fuck out. That what they are paid for.
I'm way past sick and tired of hearing them whine like children. ALL. OF. THEM.

[TheMercenary]

Kick every frigging one of them out in Nov. I have joined that group.

I just ordered some awesome bumperstickers for my truck.

[classicman]

Texas doctors opting out of Medicare at alarming rate

Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.

Two years after a survey found nearly half of Texas doctors weren't taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.

“This new data shows the Medicare system is beginning to implode,” said Dr. Susan Bailey, president of the Texas Medical Association. “If Congress doesn't fix Medicare soon, there'll be more and more doctors dropping out and Congress' promise to provide medical care to seniors will be broken.”

More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010, according to data compiled by the Houston Chronicle. Texas Medical Association officials, who conducted the 2008 survey, said the numbers far exceeded their assumptions.

The largest number of doctors opting out comes from primary care, a field already short of practitioners nationally and especially in Texas. Psychiatrists also make up a large share of the pie, causing one Texas leader to say, “God forbid that a senior has dementia.”

The opt-outs follow years of declining Medicare reimbursement that culminated in a looming 21 percent cut in 2010. Congress has voted three times to postpone the cut, which was originally to take effect Jan. 1. It is now set to take effect June 1.

Link
Is this a national, regional or local trend? Anyone know?

[jinx]

The cost of medicalizing human conditions

Medicalization of human problems is a growth industry -- but what does it cost?

The researchers, led by Brandeis sociologist Peter Conrad, evaluated 12 conditions that had been defined as medicalized by physician organizations, and for which there were current medical spending data. The other conditions considered in the study were anxiety and behavioral disorders; body image; male pattern baldness; normal sadness; obesity; sleep disorders, and substance-related disorders.



The robust trend toward ever-greater medicalization of human conditions is undeniable, with an increasing number of medical diagnoses and treatments for behavioral problems and normal life events. Conrad and his colleagues analyzed medical spending on these disorders—payments to hospitals, pharmacies, physicians and other health care providers—and discovered that they accounted for $77.1 billion in medical spending in 2005—3.9 percent of total domestic health care expenditures.


"We spend more on these medicalized conditions than on cancer, heart disease, or public health," said Conrad. "While medicalization is unlikely to be a key driver of skyrocketing health care costs, $77 billion represents a substantial dollar sum."

[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**

[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.

[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.

[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