obamaKare: the destruction begins
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QuakerOats[h=1]A Doctor's Declaration of Independence[/h][h=2]It's time to defy health-care mandates issued by bureaucrats not in the healing profession.[/h]By
DANIEL F. CRAVIOTTO JR.
Updated April 28, 2014 7:34 p.m. ET
In my 23 years as a practicing physician, I've learned that the only thing that matters is the doctor-patient relationship. How we interact and treat our patients is the practice of medicine. I acknowledge that there is a problem with the rising cost of health care, but there is also a problem when the individual physician in the trenches does not have a voice in the debate and is being told what to do and how to do it.
As a group, the nearly 880,000 licensed physicians in the U.S. are, for the most part, well-intentioned. We strive to do our best even while we sometimes contend with unrealistic expectations. The demands are great, and many of our families pay a huge price for our not being around. We do the things we do because it is right and our patients expect us to.
So when do we say damn the mandates and requirements from bureaucrats who are not in the healing profession? When do we stand up and say we are not going to take it any more?
The Centers for Medicare and Medicaid Services dictates that we must use an electronic health record (EHR) or be penalized with lower reimbursements in the future. There are "meaningful use" criteria whereby the Centers for Medicare and Medicaid Services tells us as physicians what we need to include in the electronic health record or we will not be subsidized the cost of converting to the electronic system and we will be penalized by lower reimbursements. Across the country, doctors waste precious time filling in unnecessary electronic-record fields just to satisfy a regulatory measure. I personally spend two hours a day dictating and documenting electronic health records just so I can be paid and not face a government audit. Is that the best use of time for a highly trained surgical specialist?
This is not a unique complaint. A study commissioned by the American Medical Association last year and conducted by the RAND Corp. found that "Poor EHR usability, time-consuming data entry, interference with face-to-face patient care, inefficient and less fulfilling work content, inability to exchange health information between EHR products, and degradation of clinical documentation were prominent sources of professional dissatisfaction."
In addition to the burden of mandated electronic-record entry, doctors also face board recertification in the various medical specialties that has become time-consuming, expensive, imposing and a convenient method for our specialty societies and boards to make money.
Meanwhile, our Medicare and Medicaid reimbursements have significantly declined, let alone kept up with inflation. In orthopedic surgery, for example, Medicare reimbursement for a total knee replacement decreased by about 68% between 1992 and 2010, based on the value of 1992 dollars. How can this be? Don't doctors have control over what they charge for their services? For the most part, no. Our medical documentation is pored over and insurers and government then determine the appropriate level of reimbursement.
I don't know about other physicians but I am tired—tired of the mandates, tired of outside interference, tired of anything that unnecessarily interferes with the way I practice medicine. No other profession would put up with this kind of scrutiny and coercion from outside forces. The legal profession would not. The labor unions would not. We as physicians continue to plod along and take care of our patients while those on the outside continue to intrude and interfere with the practice of medicine.
We could change the paradigm. We could as a group elect not to take any insurance, not to accept Medicare—many doctors are already taking these steps—and not to roll over time and time again. We have let nearly everyone trespass on the practice of medicine. Are we better for it? Has it improved quality? Do we have more of a voice at the table or less? Are we as physicians happier or more disgruntled then two years ago? Five years ago? Ten years ago?
At 58, I'll likely be retired in 10 years along with most physicians of my generation. Once we're gone, who will speak up for our profession and the individual physician in the trenches? The politicians? Our medical societies? Our hospital administrators? I think not. Now is the time for physicians to say enough is enough.
Dr. Craviotto is an orthopedic surgeon in Santa Barbara, Calif., and a fellow of the American Academy of Orthopedic Surgeons.
http://online.wsj.com/news/articles/SB10001424052702304279904579518273176775310#printMode -
HitsRus
I said a few posts ago that our increase was 24.2% for SIMILAR plan .... that is the same deductible and drug benefits which are the most important items to my employees remained the same. Everything else in the plan went up significantly...i.e. max out of pocket doubled, ER visits went from $75 to $150 etc. For an apples to apples plan, I don't remember the numbers but it was so high it was out of consideration.The average increase in total cost per plan has been found to be about 40% when comparing apples to apples -
BGFalcons82
Harry Reid would call your story a bald-faced lie.HitsRus;1610576 wrote:I said a few posts ago that our increase was 24.2% for SIMILAR plan .... that is the same deductible and drug benefits which are the most important items to my employees remained the same. Everything else in the plan went up significantly...i.e. max out of pocket doubled, ER visits went from $75 to $150 etc. For an apples to apples plan, I don't remember the numbers but it was so high it was out of consideration. -
QuakerOatsPosted May 3, 2014 - 6:53pm Updated May 4, 2014 - 10:49am
Own a small business? Brace for Obamacare pain
By JENNIFER ROBISON
LAS VEGAS REVIEW-JOURNAL
"Local business owners might be hoping the Affordable Care Act’s insurance mandates cover sticker shock.
The law’s employer coverage mandate doesn’t take effect until 2015, but early plan renewals are starting to roll in. And for some businesses, the premium jumps are positively painful.
Local insurance brokers are reporting spikes ranging from 35 percent to 120 percent on policies that renew from July to December. The increases are especially acute among employers with workforces made up of younger, healthier men. That’s because Obamacare prohibits offering lower rates to healthier groups. It also narrows the allowed premium gap between older and younger enrollees.
“It’s like if there were no more safe-driver discounts with State Farm,” said local insurance broker Frank Nolimal of Assurance Ltd. “Everybody has the same rate, whether you have three DUIs, or you’re a (nondrinking) churchgoing Mormon.”
The changes put as many as 90,000 policies across Nevada at risk of cancellation or nonrenewal this fall, said Las Vegas insurance broker William Wright, president of Chamber Insurance and Benefits. That’s more than three times the 25,000 enrollees affected in October, when Obamacare-compliant plans first hit the market.
Some workers are at higher risk than others of losing company-sponsored coverage. Professional, white-collar companies such as law or engineering firms will bite the bullet and renew at higher prices because they need to compete for scarce skilled labor, Nolimal said.
But moderately skilled or low-skilled people making $8 to $14 an hour working for landscaping businesses, fire-prevention firms or fencing companies could lose work-based coverage because the plans cost so much relative to salaries.
Employees who keep their coverage might see leaner take-home pay, which could hurt the economy.
Nolimal said one business client whose monthly premiums will rise from $160 to $340 in June plans to shift most of the increase onto his employees.
“Just like when you see gasoline prices going up an extra dime a gallon, it takes money out of the economy for things like buying a new stereo or having dinner out on the town,” Nolimal said.
The premium hikes could have political implications, as well. Nolimal estimated that as many as 85 percent of small-group plans will renew in November and December. Because new premiums go out 60 days before coverage takes effect, those price hikes will hit mailboxes in September and October — just before November’s elections."
Change we can believe in .... -
QuakerOatsOver $5 Billion and Counting for Obamacare Websites...
Can't build a website, yet liberals want them to have charge over your health care.
The Insanity Tour rolls on ..... -
QuakerOatshttp://www.foxnews.com/politics/2014/05/14/obamacare-contractor-pays-employees-to-do-nothing-whistleblower-says/
obamaKare firm pays workers to do nothing.
The obamaKare Fraud Machine rolls on ........ -
BGFalcons82
But Bush did it, so there's nothing new here. Move along...QuakerOats;1616112 wrote:http://www.foxnews.com/politics/2014/05/14/obamacare-contractor-pays-employees-to-do-nothing-whistleblower-says/
obamaKare firm pays workers to do nothing.
The obamaKare Fraud Machine rolls on ........ -
gutThis Veteran Affairs scandal is the canary in the coal mine for Obamakare.
I will NEVER understand what leads liberals to believe that more govt is better. -
QuakerOatsBecause they only feel secure being in a large herd where bigger is better ..... for themselves.
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believer
There's political power and money to be made in convincing the sheeple that they are incapable of making their own decisions.gut;1618261 wrote:This Veteran Affairs scandal is the canary in the coal mine for Obamakare.
I will NEVER understand what leads liberals to believe that more govt is better. -
BoatShoes
The Veterans Administration and Obamacare are nothing alike lol.gut;1618261 wrote:This Veteran Affairs scandal is the canary in the coal mine for Obamakare.
I will NEVER understand what leads liberals to believe that more govt is better. -
gut
Correct....VA actually works, just not very well.BoatShoes;1618913 wrote:The Veterans Administration and Obamacare are nothing alike lol. -
BoatShoes
Keep imagining that the affordable care act is not working as it was devised. It is hilarious to go back and read the doomsday prophecies back in October that never came to pass. Not like you will change your mind though lol.gut;1618915 wrote:Correct....VA actually works, just not very well. -
QuakerOatsBoatShoes;1618959 wrote:Keep imagining that the affordable care act is not working as it was devised. It is hilarious to go back and read the doomsday prophecies back in October that never came to pass. Not like you will change your mind though lol.
Lying is not the answer.
Then again truth, honesty and integrity have never been a hallmark of legal 'profession'. -
gut
Kind of putting the cart before the horse, aren't you? There's what, maybe 6M signed up so far? It's been incredibly disruptive and, at its very best, adds no value (most likely we will see increases in costs and inefficiencies, probably quite significant).BoatShoes;1618959 wrote:Keep imagining that the affordable care act is not working as it was devised. It is hilarious to go back and read the doomsday prophecies back in October that never came to pass. Not like you will change your mind though lol.
Typical govt boondoggle - big distraction and disruption with no economic value. I'm guessing your one of the people who thinks insurance companies are insanely profitable and inefficient, and squeezing their margins will save billions. -
QuakerOatsVA Admits 23 Veteran Deaths Linked to Delays in Care..
De facto death panels ...............and we haven't even gotten to obamaKare yet !! -
Dr Winston O'Boogie
You are so consumed by Obama that it's comical. This VA thing, while horrible, could have easily happened during any presidency. It's got nothing to do with Obamacare. Trying to make the leap from this to the ridiculous "death panels" assertion is fanciful. The "death panels" idea was started by Sarah Palin, so that should tell you everything you need to know about that subject.QuakerOats;1619151 wrote:VA Admits 23 Veteran Deaths Linked to Delays in Care..
De facto death panels ...............and we haven't even gotten to obamaKare yet !! -
HitsRus
It was devised to double what I pay for my employees and my health care and for a lesser policy? Small business and their employees are getting hammered ... If this is what obummerKare was ​devised for, it is working swell!BoatShoes;1618959 wrote:Keep imagining that the affordable care act is not working as it was devised. It is hilarious to go back and read the doomsday prophecies back in October that never came to pass. Not like you will change your mind though lol. -
QuakerOatsBoatShoes;1618913 wrote:The Veterans Administration and Obamacare are nothing alike lol.
FLASHBACK Obama 2008: VA to be 'leader of national health-care reform'... -
QuakerOatsDr Winston O'Boogie;1619259 wrote:You are so consumed by Obama that it's comical. This VA thing, while horrible, could have easily happened during any presidency. It's got nothing to do with Obamacare. Trying to make the leap from this to the ridiculous "death panels" assertion is fanciful. The "death panels" idea was started by Sarah Palin, so that should tell you everything you need to know about that subject.
FLASHBACK Obama 2008: VA to be 'leader of national health-care reform'... WEAR THAT !!
And as for the death panels, to say that Sarah Palin started that lingo is liberal lunacy at its finest. The death panels are enumerated in the ACA law; they are formally known as IPAB, but those with half a brain know how they really work in practice. obamaKare will result in worse care; more costly care; and tens of millions still without insurance --------- WOW, WHAT A FUCKING SUCCESS STORY THAT IS. -
gut
We spent BILLIONS to basically sign-up people for Medicaid that weren't aware they qualified. Only the gubmit could pat themselves on the back for flushing that much money down the toilet.QuakerOats;1619272 wrote:WOW, WHAT A FUCKING SUCCESS STORY THAT IS. -
QuakerOatsIt's lucky for these jackasses that they are in government; they wouldn't last two weeks in the real world.
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Dr Winston O'Boogie
I work in the "real world" at a corporation. There are really good people there and plenty of "jackasses" too. They seem to be making it just fine in spite of their less than steller attitudes.QuakerOats;1619283 wrote:It's lucky for these jackasses that they are in government; they wouldn't last two weeks in the real world. -
believer
This government - in particular the Obama Administration - continually pats itself on their backs at the sheer audacity and magnitude of their on-going fiscal ineptitude.gut;1619276 wrote:We spent BILLIONS to basically sign-up people for Medicaid that weren't aware they qualified. Only the gubmit could pat themselves on the back for flushing that much money down the toilet. -
QuakerOatsObamacare Taxes: Next Filing Season Could Be 'most chaotic in years'...
Change we can believe in ...