Obamacare puts the squeeze on Hospitals, the uninsured, and Physicians!

By Ben Shapiro in Breitbart

Missouri Republicans are fighting back against the imposition of Obamacare, stating that costs to the state far outweigh any potential benefits of the program. Obamacare wants states to expand their Medicaid rolls, with the state eventually picking up a significant portion of the tab; at the outset, though, for each state dollar spent on Medicaid expansion, the federal government will pick up $19.

Hospitals are claiming they want the Medicaid expansion, but state lawmakers say there just isn’t money available. The hospitals have been put between a rock and a hard place, since Obamacare phases out funding for hospitals that serve low-income, uninsured patients in an attempt to force the state to pay for it.


That is the entire Obamacare agenda. By forcing hospitals to care for people who are low-income, the federal government hopes to leverage the states. If the states refuse, the federal government cuts off funding but retains the regulations, forcing hospitals into bankruptcy. Then Democrats can claim that the private system has failed to provide for those needy folks, and enact a public option.

Canadian Physicians must be Board Eligible or Board Certified to practice in the U.S.

Canadian Physicians seeking to practice in the U.S. have several boxes to check. The most important is the one that enable the Canadian trained physician to be American Board Eligible and Board Certified. Every hospital, health system, and other health care organization will only work with BE/BC physicians. Period! For reimbursement reasons all physicians must be BE/BC or insurance companies are not paying the bill.

So how can a Canadian trained physician become BE/BC, and able find a job in the U.S.

State licenses:

For a physician who has been trained in Canada, getting any State license should not be a concern. They are not considered to be a foreign medical grad. Take PA for instance; The PA licensing board should not have a concern with Canadian training.

American Boarded:

For a physician to have completed their Canadian training and to be eligible to sit for their American Boards. To be eligible to sit for the American Board of Medical Specialties, they must have been a member of the Royal College of Physicians and Surgeons of Canada. This will qualify him to apply for certification with the American Boards.

Obamacare will not work! One - there is no malpractice reform! Two: U.S. Military must be kept as the worlds top military (Canada for example has a weak military, and they are happy to have it that way)!

Even as far back as 2006 the Canadian system was failing, but nothing has been done to fix it. Infact, today we see Physicians in Canada are paid less, and see lower amounts of patients. ObamaCare has American heading straight to the Canadian system, but it will fail in America (patients will suffer!). TWO BIG REASONS:

1) America spends 4 times as much in GDP that works out to $7,110,000,000/yr. Canada spends just 1.4% of it’s GDP on defense (hey why spend on defense when you (Canada) have a 500lb Gorilla (U.S. Military) protecting you.

2) The American legal system makes it’s best living in Malpractice lawsuits. Yep, the Trail Lawyers donate more money than any other lobbying group, and the Dems get all that money. There is tort reform in Canada with caps in place. Only in Texas will you find Malpractice Tort reform. The malpractice lawyers are ripping the system-off blind!

Canada's Private Clinics Surge as Public System Falters

By CLIFFORD KRAUSS

Published: February 28, 2006

VANCOUVER, British Columbia, Feb. 23 — The Cambie Surgery Center, Canada's most prominent private hospital, may be considered a rogue enterprise.

Accepting money from patients for operations they would otherwise receive free of charge in a public hospital is technically prohibited in this country, even in cases where patients would wait months or even years before receiving treatment.

But no one is about to arrest Dr. Brian Day, who is president and medical director of the center, or any of the 120 doctors who work there. Public hospitals are sending him growing numbers of patients they are too busy to treat, and his center is advertising that patients do not have to wait to replace their aching knees.

The country's publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — is gradually breaking down. Private clinics are opening around the country by an estimated one a week, and private insurance companies are about to find a gold mine.

Dr. Day, for instance, is planning to open more private hospitals, first in Toronto and Ottawa, then in Montreal, Calgary and Edmonton. Ontario provincial officials are already threatening stiff fines. Dr. Day says he is eager to see them in court.

"We've taken the position that the law is illegal," Dr. Day, 59, says. "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."

Dr. Day may be a rebel (he keeps a photograph of himself with Fidel Castro behind his desk), but he appears to be on top of a new wave in Canada's health care future. He is poised to become the president of the Canadian Medical Association next year, and his profitable Vancouver hospital is serving as a model for medical entrepreneurs in several provinces.

Canada remains the only industrialized country that outlaws privately financed purchases of core medical services. Prime Minister Stephen Harper and other politicians remain reluctant to openly propose sweeping changes even though costs for the national and provincial governments are exploding and some cancer patients are waiting months for diagnostic tests and treatment.

But a Supreme Court ruling last June — it found that a Quebec provincial ban on private health insurance was unconstitutional when patients were suffering and even dying on waiting lists — appears to have become a turning point for the entire country.

"The prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services," the court ruled.

In response, the Quebec premier, Jean Charest, proposed this month to allow private hospitals to subcontract hip, knee and cataract surgery to private clinics when patients are unable to be treated quickly enough under the public system. The premiers of British Columbia and Alberta have suggested they will go much further to encourage private health services and insurance in legislation they plan to propose in the next few months.

Private doctors across the country are not waiting for changes in the law, figuring provincial governments will not try to stop them only to face more test cases in the Supreme Court.

One Vancouver-based company started a large for-profit family medical clinic specializing in screening and preventive medicine here last November. It is planning to set up three similar clinics — in Toronto, Ottawa and London, Ontario — next summer and nine more in several other cities by the end of 2007. Private diagnostic clinics offering MRI procedures are opening around the country.

Canadian leaders continue to reject the largely market-driven American system, with its powerful private insurance companies and 40 million people left uninsured, as they look to European mixed public-private health insurance and delivery systems.

"Why are we so afraid to look at mixed health care delivery models when other states in Europe and around the world have used them to produce better results for patients at a lower cost to taxpayers?" the premier of British Columbia, Gordon Campbell, asked in a speech two weeks ago.

While proponents of private clinics say they will shorten waiting lists and quicken service at public institutions, critics warn that they will drain the public system of doctors and nurses. Canada has a national doctor shortage already, with 1.4 million people in the province of Ontario alone without the services of a family doctor.

"If anesthetists go to work in a private clinic," Manitoba's health minister, Tim Sale, argued recently, "the work that they were doing in the public sector is spread among fewer and fewer people."

But most Canadians agree that current wait times are not acceptable.

The median wait time between a referral by a family doctor and an appointment with a specialist has increased to 8.3 weeks last year from 3.7 weeks in 1993, according to a recent study by The Fraser Institute, a conservative research group. Meanwhile the median wait between an appointment with a specialist and treatment has increased to 9.4 weeks from 5.6 weeks over the same period.

Average wait times between referral by a family doctor and treatment range from 5.5 weeks for oncology to 40 weeks for orthopedic surgery, according to the study.

Last December, provincial health ministers unveiled new targets for cutting wait times, including four weeks for radiation therapy for cancer patients beginning when doctors consider them ready for treatment and 26 weeks for hip replacements.

But few experts think that will stop the trend toward privatization.

Dr. Day's hospital here opened in 1996 with 30 doctors and three operating rooms, treating mostly police officers, members of the military and worker's compensation clients, who are still allowed to seek treatment outside the public insurance system. It took several years to turn a profit.

Today the center is twice its original size and has yearly revenue of more than $8 million, mostly from perfectly legal procedures.

Over the last 18 months, the hospital has been under contract by overburdened local hospitals to perform knee, spine and gynecological operations on more than 1,000 patients.

 

Medicaid is growing, and Physician earnings are dropping! Health systems are now only receiving 16 cents on every dollar $ billed!

Record 70.4 Million Enrolled in Medicaid in 2011: 1 Out of Every 5 Americans

By Matt Cover

November 9, 2012

 

 

(CNSNews.com) – A record 70.4 million people were enrolled in the Medicaid health care program for the poor in fiscal year 2011, according to government figures provided to CNSNews.com.
That figure equals about 22 percent of the population, which means there was one person on Medicaid for every 5 Americans in 2011.
The record number of Medicaid enrollees in 2011 – the earliest year for which figures are available – is a count of all persons enrolled in Medicaid for any part of that year, providing the fullest and most accurate count of the size of the entitlement program. (The federal fiscal year in 2011 ran from Oct. 1, 2010 to Sept. 30, 2011.)
Figures provided to CNSNews.com by the Centers for Medicare and Medicaid Services (CMS), the agency that oversees the two health care entitlements, reveal an ever-expanding Medicaid program. From 2005 to 2011, total enrollees grew by more than 10 million people, going from 60.1 million in 2005 to 70.4 million in 2011.
Medicaid is the joint federal-state health care program for the poor that allows states to extend coverage beyond those who are in poverty. Recently, the ObamaCare health reform law expanded Medicaid eligibility to those living on 133 percent of the federal poverty level.
The poverty level annual income for a family of four is $23,000 – 133 percent of that, in terms of annual income for a family of four, would be $30,590.
That expansion does not go into effect until 2014, however, and therefore does not affect the continued growth trend. Nor does it contribute to the record 70.4 million Americans enrolled in Medicaid.

 

According to CMS statistics, Medicaid has been growing rapidly since 2008, going from 62.8 million total enrollees to 70.4 million in 2011. Prior to 2008, Medicaid rolls had remained relatively stable, going from 60.1 million in 2005 to just 60.9 million in 2007.
While Medicaid rolls would be expected to rise during a recession, as they did in 2008 and 2009, the last recession ended in June 2009 and Medicaid rolls have expanded faster than during the 2005-2008 period. Medicaid rolls have grown by 5.2 million Americans since 2009 – when the recession ended and the economy began to grow again slightly.
Despite a period of modest gains in employment and economic growth, Medicaid rolls have grown to their record high of 70.4 million Americans.

Under Obamacare physicians are just another Assembly Line Healthcare worker! Obamacare shuts down private practices!

by Dr. Susan Berry8 Nov 2012

With the re-election of President Barack Obama, the Affordable Care Act's regulations will continue to roll out through 2014.

There will be new rules for how the states and the federal government will run the new health insurance “exchanges.” Insurance companies will have their rules regarding premiums they can charge and the customers they will be required to sign up, regardless of medical history. As for individual Americans, we will be required to present evidence of a “government-defined” health insurance plan to the IRS when we file our tax returns.
But, what about doctors, specifically those who own their own practices? Doctor-owned practices are places where health care is provided, but they are also small businesses, operated by small-business owners and entrepreneurs, the doctors themselves.
Doctors who own their own practices have the same costs as other small businesses: rent or mortgage, staff salaries and benefits, utilities, computers, equipment, furniture, etc. As small businesses that have suffered along with others under the first Obama administration, there is no reason yet to believe they won’t suffer more under the second, particularly when Obama and the Democrats want to increase taxes on those who make $250,000 or more. For those health care providers who have practices with many employees, the issue of the ObamaCare employer mandate to provide health insurance for them is another factor of the decision regarding whether a practice is sustainable.
For health providers who rely on health insurance as third party payers, lower reimbursement rates over the years have greatly impacted small business practices. Most Americans would never accept a job in which their prospective employer told them they would get paid less and less each year they work for the business. Yet, health providers agree to this all the time in the system we have had prior to the era of ObamaCare, a system that is equally dysfunctional.
As a result of lowered Medicare reimbursements, for example, more doctors will now be denying care to our seniors. The $716 billion that ObamaCare steals from Medicare is the reimbursement funding that is supposed to have gone to Medicare providers. Gone with the re-election of Obama.
For those health providers who are “fee for service,” meaning that patients pay them directly for services without insurance as another intervening element of the transaction, the Obama economic decline has led to high unemployment and, consequently, less customers who can pay fees. Health providers who are small business owners have experienced significant drops in income and the reality that they must pay for office expenses with what would have been personal income. Mental health providers are often in this category, having left insurance-based practices because of the extremely low reimbursement rates by health insurance companies in this specialty area.
Doctoral level mental health providers could once have a successful business because many patients preferred to pay them privately to protect themselves from having a mental health diagnosis on their health insurance records. However, with so many Americans out of work, many fee-for-service practices are barely surviving. With the new rules and regulations of ObamaCare, most will close.
The fact is that the costs of complying with all the ObamaCare regulations makes it difficult to sustain doctor-owned practices. With the government now mandating that doctors use electronic records, so that information is easier to share, the costs to implement the requirements will belong to health providers.
Under ObamaCare, many, if not most, doctors will be forced into hospital employment or Accountable Care Organizations (ACO). That means they will no longer be their own bosses, no longer make the decisions about their individual practices and, consequently, no longer have the same level of responsibility for the health care that is delivered. As we have seen in most bureaucratic systems that are reliant upon the government in some way, the buck always stops someplace higher up.
Perhaps some doctors will like being a “company man or woman,” because they won’t have to worry about complying with all the new ObamaCare regulations and administrative issues in their own practices. Instead, they can just show up, treat healthcare problems, collect a salary, and let someone else worry about the business end of it.
Like other small businesses, doctor-owned businesses are facing a forceful blow. Health care business owners can either spend all the money and time required to comply with ObamaCare -- money and time taken away from their personal incomes and further investment in their business practices -- or close up shop and become just another health care worker on the assembly line that is life.

Medicaid verse Medicare, and Obamacare closing access and hospitals!

Record 70.4 Million Enrolled in Medicaid in 2011: 1 Out of Every 5 Americans By Matt Cover November 9, 2012   (CNSNews.com) – A record 70.4 million people were enrolled in the Medicaid health care program for the poor in fiscal year 2011, according to government figures provided to CNSNews.com. That figure equals about 22 percent of the population, which means there was one person on Medicaid for every 5 Americans in 2011. The record number of Medicaid enrollees in 2011 – the earliest year for which figures are available – is a count of all persons enrolled in Medicaid for any part of that year, providing the fullest and most accurate count of the size of the entitlement program. (The federal fiscal year in 2011 ran from Oct. 1, 2010 to Sept. 30, 2011.) Figures provided to CNSNews.com by the Centers for Medicare and Medicaid Services (CMS), the agency that oversees the two health care entitlements, reveal an ever-expanding Medicaid program. From 2005 to 2011, total enrollees grew by more than 10 million people, going from 60.1 million in 2005 to 70.4 million in 2011. Medicaid is the joint federal-state health care program for the poor that allows states to extend coverage beyond those who are in poverty. Recently, the ObamaCare health reform law expanded Medicaid eligibility to those living on 133 percent of the federal poverty level. The poverty level annual income for a family of four is $23,000 – 133 percent of that, in terms of annual income for a family of four, would be $30,590. That expansion does not go into effect until 2014, however, and therefore does not affect the continued growth trend. Nor does it contribute to the record 70.4 million Americans enrolled in Medicaid.   According to CMS statistics, Medicaid has been growing rapidly since 2008, going from 62.8 million total enrollees to 70.4 million in 2011. Prior to 2008, Medicaid rolls had remained relatively stable, going from 60.1 million in 2005 to just 60.9 million in 2007. While Medicaid rolls would be expected to rise during a recession, as they did in 2008 and 2009, the last recession ended in June 2009 and Medicaid rolls have expanded faster than during the 2005-2008 period. Medicaid rolls have grown by 5.2 million Americans since 2009 – when the recession ended and the economy began to grow again slightly. Despite a period of modest gains in employment and economic growth, Medicaid rolls have grown to their record high of 70.4 million Americans.Medicare reimbursement is already low, and Obamacare will decrease this reimbursement rate by another 15% to 40%. The effect will be many physicians and health systems will limit their number of Medicare patients seen. Worse yet…health systems will be forced to drop Medicare patients! A second effect will be hospitals located in areas populated by a high percentages of Medicare patients then be forced to shut their doors (close)!   Then there is Medicaid! Just check out how badly Medicaid pays physicians and hospitals for services rendered:
How much each state pays doctors for Medicaid primary care services compared to Medicare rates.
State	Pct. of Medicare Rates
AL	70%
AK	125%
AZ	86%
AR	69%
CA	43%
CO	77%
CT	72%
DE	98%
DC	94%
FL	50%
GA	70%
HI	59%
ID	91%
IL	53%
IN	55%
IA	76%
KS	82%
KY	72%
LA	76%
ME	64%
MD	74%
MA	70%
MI	51%
MN	47%
MS	90%
MO	57%
MT	102%
NE	76%
NV	71%
NH	62%
NJ	50%
NM	85%
NY	51%
NC	86%
ND	141%
OH	60%
OK	95%
OR	74%
PA	56%
RI	33%
SC	79%
SD	76%
TX	62%
UT	66%
VT	83%
VA	75%
WA	72%
WV	71%
WI	61%
WY	104%
US Avg.	61%
Source: The Urban Institute, 2010 figures.