Tag Archives: doctor revolt

Treating Medicaid patients is charity work.

Treating Medicaid patients is charity work. This bill proves it..

The enthusiasm for expanding Medicaid coverage to the previously uninsured seems misplaced. Improved “access” to the health care system via Medicaid programs surely cannot result in lasting coverage. In-network physicians will continue to dwindle as their office overhead exceeds meager reimbursement levels.

In reality, treating Medicaid patients is charity work. The fact that any physicians accept Medicaid is a testament to their generosity of spirit and missionary mindset. Expanding their pro bono workloads is nothing to cheer about. (emphasis added) The Affordable Care Act’s “signature accomplishment” is tragically flawed – because offering health insurance to people that physicians cannot afford to accept is not better than being uninsured.

After all, improved access to nothing … offers nothing. Inviting physicians to work for less than minimum wage so that politicians can crow about millions of uninsured Americans now having access to health care, is ridiculous. Medicaid expansion is widening the gap between the haves and the have-nots. The saddest part is that the have-nots just don’t realize it yet.

To the consumer, Medicaid seems like a gift. It will work for awhile until it breaks. Also, the consumer is very trusting that their past medical health is a good predictor of their future health. If for some reason, that turns out not to be the case, do you believe you or your spouse or children are getting the best treatment from the Medicaid system?

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Do the math, a Dr. Shortage is coming

Why the Doctor Can’t See You: Newsroom: The Independent Institute.

The introductory portion of the article documents how preventive care alone has the ability to create full employment for doctors. In other words, demand exceeds supply…

When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008 for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.

However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.

As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare’s newly created health insurance exchanges.

John Goodman concludes…

I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health-care system, with those who can afford it getting more care and better care.

In the meantime, the most vulnerable populations will have less access to care than they had before ObamaCare became law.

They call it Obamacare.

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Doctors grade Obamacare

Why doctors give Obamacare a failing grade | TheHill.

  •  You can keep your doctors – NOT
  • Medicaid, not so great
  • Deluge of paperwork and reporting requirements

So what grade would doctors give Obamacare?

The Physicians Foundation made shockwaves last month when it released its 2014 Survey of America’s Physicians. The survey’s top-line finding: Of the 20,000 doctors surveyed, almost 50 percent stated that Obamacare deserves either a “D” or an “F.” Only a quarter of physicians graded it as either an “A” or a “B.”

Let’s take a closer look as to how Obamacare has affected Medicaid. Many of my (potential) clients are delighted if they qualify for Medicaid or if their children qualify for CHP+. Perhaps CHP+ offers better services than Medicaid for adults but I’m doubtful.

No matter which option they chose, Obamacare forced my patients to make trade-offs between pricing, access, and quality of care.

Obamacare’s Medicaid expansion exacerbated this patient crisis. Arizona, the state in which I practice, expanded Medicaid in 2013 under the assumption that it would give the poor better access to medical care. Yet many of the new Medicaid enrollees—perhaps as many as 80 percent of them, according to one recent study—were merely forced off their private insurance plans and into Medicaid.

Several of my patients experienced this first-hand. They have found that Medicaid offers sub-standard health care compared to the private insurance they used to have. Their choice of doctors has been severely curtailed, even more so when it comes to specialists. Often they resort to the local emergency room rather than waiting weeks to get medical attention in a doctor’s office. An Oregon study revealed a 40 percent increase in ER visits among new Medicaid enrollees.

Unsurprisingly, patient health suffers when illnesses and diseases remain untreated, hence Medicaid’s persistently poor ratings on patient health. Unfortunately, my patients were forced into this broken system without a second thought.

Perhaps it was without a 2nd thought or perhaps it was with malice. The government creates a problem and then only they can fix it. Of course, with their recent displays of incompetence, they may have overplayed their hand.

Let me also comment on Medicaid. Under Medicaid, reimbursement to doctors is much less than that of regular insurance or even Medicare. I don’t care how you slice and dice it, from a big picture point of view, if the doctors don’t believe they are being fairly paid, the qualify of care dispensed is going to decrease.

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Obamacare induced Doctor Shortage – beware the Triple Threat

Ouch: Doctor Shortage Could Spell (More) Disaster for Obamacare – Cortney O’Brien.

Healthcare professionals are warning that there could be a wide gap between the number of people seeking medical treatment under Obamacare and the number of doctors available to provide it.

A triple threat — more people needing care, tens of thousands of doctors reaching retirement age and a growing number of physicians getting so frustrated with bureaucracy that they want out — could undermine any improvements the law envisages.

Personally I encourage doctors, especially primary are physicians, to stop fooling with insurance and post your prices.

 

Related: How much does surgery cost?

 

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Doctors take the road less travelled: Stop accepting insurance

Dr. Michael Ciampi, Portland, ME: South Portland doctor stops accepting insurance, posts prices online — Portland — Bangor Daily News — BDN Maine.

Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.

The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.

The change took effect April 1.

 

Dr. Ryan Neuhofel, Lawrence, KS:  The Obamacare Revolt: Physicians Fight Back Against the Bureaucratization of Health Care

Dr. Ryan Neuhofel, 31, offers a rare glimpse at what it would be like to go to the doctor without massive government interference in health care. Dr. Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that’s as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn’t accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat’s milk.

 

and we also have Dr. Lisa Davidson in Denver, CO:

Dr. Lisa Davidson had 8 years of frustration while running a successful traditional practice in Denver, Colorado. She had 6,000 patients when she decided to stop taking insurance and adopt the same business model as Neuhofel. Her patient list has dropped to about 2,000. She used to spend about 15 minutes with each patient and now it’s more like 45 minutes. “We’re on track to make more money and take better care of our patients,” says Davidson. “It’s a win-win all around.”

Here is the driving issue:

Under Obamacare, more and more doctors are becoming employees of large hospitals, where there will be more control over how they practice medicine. Hoover Institution Senior Fellow Dr. Scott Atlas fears this will cause a brain drain in medicine. “Really smart people want autonomy, and when you take that away it’s naive to think you’re going to get really bright people becoming doctors,” says Atlas. “The best doctors could excel at any profession, so why go into medicine if they won’t have the opportunity to be their best?”

and talk about cost savings…

When she was operating a traditional practice, Davidson witnessed firsthand how our “payment plans for routine expenses” drive up prices and block innovation. She recalls that one insurance company paid $118 for a routine PSA test. Now that her patients pay the bill directly the cost is $18. Insurance used to pay $128 for a bag of IV fluid. Now Davidson doesn’t bother passing on the cost of IV bags because they run $1.50 each.

I sell health insurance, so why would I be for doctors not taking insurance? Having insurance to cover day to day expenses makes no sense. That is not insurance, it is prepayment. What Obamacare does is play Robin Hood with premiums (i.e. subsidies) to tax one group so the other can afford it. That’s not insurance either. Thankfully, at least some doctors are revolting against the insurance & obamacare bureaucracies and cutting costs at the same time. Now THAT is Patient Protection and Affordable Care. Unfortunately the name has already been taken.

I am for insurance to cover major unexpected expenses. That’s what it’s for.

 

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“Drs are literally walking out of this talk on implementing,complying with Obamacare.”

Opthamologists walk out of Obamacare talk at national medical meeting | Twitchy.

OpthoDr. Kristin Held, a San Antonio-based opthamologist, is live-tweeting the American Society of Cataract and Refractive Surgery Government Relations session. The conference is being held this weekend in San Francisco.

The topic of the Government Relations session is complying with and implementing Obamacare.  Dr. Held doesn’t like what’s she’s hearing, and she’s not the only one. Indeed, almost all the doctors have walked out of the meeting.

 

Here is one of a number of tweets by Dr. Held…

Drs are literally walking out of this talk on implementing,complying with Obamacare.We are men and women of the mind not mindless drones.

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