Obamacare? No...no....no...The Fiscal Cliff will break the back of Health Care in The United States! (and will do it in only a few months!)

Here’s the take-away: On January 1^st – Physicians that accept Medicare will take a hit of 27% in Medicare Reimbursement! How can a Physician’s office, Health system, or Hospital keep the doors open with this loss of revenue? Can you say “We do not accept Medicare patients any longer”? If you can start... saying it! If you can’t....you better learn how!!!

27% Medicare Pay Cut For Doctors a Real Danger in The Fiscal Cliff

By Bruce Japsen

From Forbes    12/20/2012

Doctors face a 27 percent cut in payments from Medicare on Jan. 1. with Congress and the White House unable to come up with an agreement to avoid the so-called fiscal cliff -- or any other budgetary issues for that matter. (Photo credit: Wikipedia)

With Congress and the White House unable to come up with an agreement to avoid the so-called fiscal cliff — or any other budgetary issues for that matter — a major portion of pay for doctors from the Medicare program also hangs in the balance.

At issue is a permanent solution known as the “doc fix” for dramatic cuts to doctor payments from the Medicare health insurance program for the elderly under the so-called sustainable growth rate, or “SGR” formula. Without Congressional action, doctors face a cut in Medicare payments of nearly 27 percent on Jan. 1, 2013.

Move up http://i.forbesimg.com tMove down

Only short-term fixes – 15 of them in the last decade – have been passed as a stopgap measure to prevent major cuts in physician Medicare reimbursement. The payment formula came to be as part of the Balanced Budget Act of 1997 and has never been corrected permanently by Congress.

Unlike past years when Congress has headed off the Medicare fee cut, inaction in Washington lately on the fiscal cliff and for an entire year on the “doc fix” has the American Medical Association, the nation’s largest doctor group, and physicians across the country worried there will not even be a stopgap measure this time around.

“The threat is real,” AMA president Dr. Jeremy Lazarus said in an interview. “For physician practices, it is a terrifying situation.”

The Obama administration’s latest offer to avoid the fiscal cliff to U.S. House Speaker John Boehner and Republicans in Congress includes a repeal of the SGR, which could cost more than $240 billion. Here is a link to a Washington Post story on the repeal of the ‘doc fix.”

The GOP hasn’t warmed to White House proposals, which has many lobbies for doctors worried medical-care providers are going to take a financial hit this time.

Lazarus said doctors who treat Medicare patients face a significant amount of revenue loss. “You are talking anywhere from $10,000 or $15,000 up to $35,000 per physician,” Lazarus said.

The cut will also be immediate on Jan. 1 because the Obama administration has told doctors it will not delay processing of Medicare claims.

A Medicare fee cut could also impact insurance companies like Humana (HUM), Aetna (AET), UnitedHealth Group (UNH) and other private health insurers with large businesses providing benefits to seniors through Medicare Advantage plans. Such privately operated plans contract with Medicare to provide seniors health benefits.

A cut in doctor fees would also harm what the health plans can pay doctors and could also result in physicians fleeing health plan networks, physicians say. Already, one-third of physicians who treat Medicare patients are not accepting new patients, the AMA says, in part because they are unhappy with what the program pays them.

“We haven’t seen anything as of yet that will avert that cut on Jan. 1,” Lazarus said. “With a full year to stop this drastic cut, it is absolutely inexcusable that Congress has failed to act, leaving Medicare patients and physicians to deal with the consequences.”

 

 

Obamacare will make Medical Malpractice Lawyers very rich men!!

H/T NY Daily News

Without real Tort Reform Obamacare will cause our Medical System to go bankrupt! We all know that Trail Lawyers are Obama’s top political donors, so the chance of Obama pushing for Malpractice Reform will be ZERO!

Obamacare will fail without tort reform: Malpractice insurance costs are crippling medicine

By Dr. Michael Lavyne

Friday, November 19, 2010, 4:00 AM

I am what you call a successful neurosurgeon, and I have nothing against "socialized medicine" as such. Everybody deserves good health care. But I am nonetheless worried about President Obama's health care reform, because without tort reform as part of the package, it can't address the labor shortage we face in my specialty.

Tort reform is crucial because it would curtail the threat of frivolous malpractice lawsuits, reward all patients who have been injured by medical mishaps, not just the wealthy with access to high-powered lawyers - and reduce the anxieties faced by young doctors going into medicine in the first place, especially those entering high-stakes fields like my own.

For example, I just operated on a 60-year old man who didn't even know his surgery was an emergency. He was losing motor function in his lower extremities due to severe spinal stenosis, and we were able to move quickly because we were free of insurance issues. But what if those insurance issues were paramount? What if somebody like me wasn't available, to anybody, because the supply of neurosurgeons had dried up - because the costs of letting them operate were too high? Would he still be walking?

Good doctors have always been in short supply; why worry especially about neurosurgery?

Only because spinal problems affect nearly 80% of our aging population: It's one of the most common reasons patients visit a primary care physician, right behind the yearly physical, the common cold, prenatal care and anxiety-related disorders. Baby boomers are about to overwhelm the system with demand for treatment of spinal problems - including surgery - at precisely the moment the supply of neurosurgeons able to treat them is dwindling.

How could this have happened? How could we have a labor shortage in one of the most lucrative, prestigious and desperately needed medical specialties?

One reason is the difficulty of getting certified, which makes sense. In May of 2009, the American Board of Neurological Surgeons certified 59 individuals as capable of tasks required of their specialty. But only about 30% of them, just 18 people, were ready to perform the surgeries that might solve the spinal problems of an aging population. The average age of these people was 37, they all carried loans from medical school and malpractice insurance premiums they faced were about $4.5 million a year if they settled in this state.

Thus we come to the second reason: the cost of malpractice insurance, which creates a very high cost of entry into this field. Unfortunately, the health care reforms of the Obama administration have done little to curb costs. These costs are imposed by hospital inefficiencies as unpoliced by government-run insurance plans and by the price of malpractice insurance undisciplined by tort reform.

I believe that tort reform is the key to reducing both kinds of cost, because the malignant threat of malpractice haunts the hospitals as well as the physicians. Without such reform, the choice for practicing neurosurgeons like me is between retirement and working 24/7 just to cover my insurance overhead. My premature retirement will reduce the supply of surgeons capable of dealing with the spinal problems of an aging population - and that supply is already short and getting shorter. Meanwhile, a few more board-certified surgeons a year won't meet the growing demand. The lines at your doctor's office could get long.

When Congress returns to consider the problem of health care, it must understand that without tort reform, neurosurgery of the kind I can provide to an aging population will be unavailable.

Lavyne is Clinical Professor of Neurological Surgery at Weill Cornell Medical College of Cornell University in New York City.

Obamacare....Physicians will be paid less, and pay higher taxes!

Obamacare

Health Care Reform: What Will It Mean for You in 2013?

---

Many Physicians will face higher tax bills Jan. 1, 2013, as a result of four health care-reform law changes.
Here's a look at what's about to hit — unless Congress otherwise acts (and we know they won't)!

What's Coming Jan. 1

1. Limit on flexible spending account (FSA) contributions. Today, employers set their own caps on how much employees can contribute to these plans that let them use pretax money to pay for health care expenses. For 2013, the government will enforce a $2,500 limit per employee.

2. A new Medicare surtax on investment income. Until now, Medicare taxes have only applied to earned income. For 2013, taxpayers filing individually with wages and self-employment income above $200,000 ($250,000 for married couples filing jointly) will pay a 3.8% surtax on the lower of:

• Their net investment income — which includes interest, dividends, capital gains and other amounts.
• The amount of their modified adjusted gross income that is greater than $200,000 ($250,000 for married couples filing jointly).

3. An additional Medicare tax on wages and self-employment income for some. The existing Medicare payroll tax of 2.9% (of which 1.45% is paid by a taxpayer through payroll deductions) will be increased by 0.9% on wages or self-employment income that exceeds $200,000 for single and qualifying head of household and widow(er) filers ($250,000 for married couples filing jointly).

4. Higher hurdle for deducting medical expenses. Currently, out-of-pocket medical costs only are deductible to the extent they exceed 7.5% of your adjusted gross income. For 2013, that hurdle will rise to 10%. But if you're 65 or older, that threshold remains frozen at 7.5% through 2016.

Please ask the AMA how Obamacare will benefit physicians?

Physicians paid less under Obamacare, and if a patient suffer because hospitals will be forced to block re-admissions!

Obamacare decreases Physician salaries, increase wait time to see a physician, and will force patients to find a new way to receive care.

7 things that scare your doctor with ObamaCare on the horizon

By Dr. Sreedhar Potarazu

Published December 05, 2012

FoxNews.com

As the Affordable Care Act is in full swing, there’s a lot of apprehension and perhaps, sometimes, enthusiasm about what is truly in store for the medical profession.

The last time you visited your doctor you may have noticed that he or she was more apprehensive, cautious, and yes, maybe more overwhelmed. The fact of the matter is that the health care profession is undergoing the most significant renovation to ever happened in the history of the United States.

Here are many things that keep many doctors awake at night:

1. A new wave of new patients.
Now that insurance companies must accept people with pre-existing conditions, and dependents under the age of 26, there is a new floodgate that has opened, which will bring more people into the system to see a primary care physician. In addition, many states will be expanding their Medicaid rosters, which will also introduce a greater volume of patients all competing for a limited number of physicians.

The projected shortage in primary care physicians between now and the year 2020 is expected to exceed 90,000 by some estimates, which means we have a real supply and demand issue. Either physicians will have to extend their hours and see more patients, or patients will have to wait longer to get an appointment.

2. The paycheck could start shrinking.
Although one would think that a rise in patient volume would correlate into higher income, reimbursements for many specialties could, in fact, be reduced under ObamaCare. There are proposed cuts of almost $718 billion out of Medicare, which will be based on reduced reimbursements and reduction in fraud and waste in the health care system. There is no question that there is room for improvement in reducing the number of unnecessary or duplicate tests being done, but the real concern for doctors is a lot of these decisions will be made by IPAB, the Independent Payment Advisory Board, which will dictate the standards.

3. The wonders of technology.
Every physician is now required to implement an electronic medical record as a means of standardizing information gathering and sharing in the health care industry. This is a good idea. The problem is that in order for a physician to effectively implement a new system, they need to cancel patients for a few months in order to accommodate the transition in learning, which in turn, creates a backlog.

There is, of course, the cost of implementing a new system that will eat into the profits a doctor already earns (and is potentially diminishing). Doctors may even need to hire newly skilled staff to manage these systems and convert their manual records to an electronic one. Technology is important, but the road to success will be rocky.

4. Decreased face time.
With a increasing volume of patients and increased demands on technology and reduced reimbursement, what might ultimately happen is that patients spend less time with their doctor - less than even the average seven minutes. The domino effect from here is that patients get less questions answered, and doctors are more exposed to missing things in the process. In addition, there is the likelihood this could lead to more tests being ordered because there is simply no time to take a good history that is often the crux of an accurate diagnosis.

5. Staying connected.
A major part of the new delivery system is accountable care organizations, which are designed to improve coordination between doctors, hospitals, patients and care takers. Many doctors will soon be reimbursed through a bundled fee for the services that are delivered for an individual for all of the doctors responsible. It will now be critical that doctors are able to understand what tests and evaluations were done before and after a patient’s visit in order to best be able to coordinate care.

6. Hospitals are punished if discharged patients must be re-admitted.

Hospitals will be penalized if patients come back within a certain period of time, and it will be very important for them to be able to communicate with the primary care doctors to make sure the patient complies with their appointments, medications and any other care.

7. The doctor-patient relationship.
As insurance companies try to get more market share, many of them are buying up doctors' practices and aligning themselves with hospitals to create a monopoly. This is not very different from the days of managed care. Most of us are used to physician choice, and there is nothing more special than the relationship with our doctor. The trend remains that with future consolidation of the market, many doctors could be excluded from certain networks , and you may no longer be able to see the doctor of your choice.
The years 2013 and 2014 will be big years for the health care profession and the next time you visit your doctor, you might put these points into perspective, as this might ultimately impact the future of your care.

Dr. Sreedhar Potarazu

Obamacare: physicians have a big pay cut - States do not want to expand Medicaid and get stuck with the bill!

Physicians will have a huge pay cut! States will have to pay for the increase in Medicaid costs.....Ah....where will they get the money?

 

H/T PNJ.com

WASHINGTON — It’s health care brinksmanship, with hundreds of billions of dollars and the well-being of millions of people at stake.

President Barack Obama’s health care law expands Medicaid, the federal-state health program for low-income people, but cost-wary states must decide whether to take the deal.

Turn it down, and governor’s risk coming off as callous toward their neediest residents. Not to mention the likely second-guessing for walking away from a pot of federal dollars estimated at nearly $1 trillion nationally over a decade.

If the Obama administration were to compromise, say by sweetening the offer to woo a reluctant state, such as Florida has been under Gov. Rick Scott, it would face immediate demands from 49 others for similar deals that could run up the tab by tens of billions of dollars.

As state legislatures look ahead to their 2013 sessions, the calculating and the lobbying have already begun.

Conservative opponents of the health care law are leaning on lawmakers to turn down the Medicaid money. Hospitals, doctors groups, advocates for the poor, and some business associations are pressing them to accept it.

“Here’s the big thing: The state does not want to expand Medicaid and get stuck with the bill,” said Dr. Bill Hazel, Virginia’s health secretary.

Medicaid covers nearly 60 million low-income and disabled people but differs significantly from state to state. Under the health care law, Medicaid would be expanded on Jan. 1, 2014, to cover people making up to 138 percent of the federal poverty line, or about $15,400 a year for an individual.

In Florida, where Scott says he is rethinking his opposition, the state could end up saving money through the Medicaid expansion, said Joan Alker, executive director of the Georgetown University Center for Children and Families, which studied the financing.

The reason is Florida would spend less on a state program for people with catastrophic medical bills.

Florida has an estimated 3,952,000 uninsured residents. Alabama, which has no plans to expand Medicaid, has 696,000 uninsured residents.

About half the 30 million people gaining coverage under the law would do so through Medicaid. Most of the new beneficiaries would be childless adults, but about 2.7 million would be parents with children at home. The federal government would pay the full cost of the first three years of the expansion, gradually phasing down to a 90 percent share.

The Supreme Court said states can turn down the Medicaid expansion. But if a state does so, many of its poorest residents would have no other way to get health insurance.

The subsidized private coverage also available under Obama’s law is only for people making more than the poverty level, $11,170 for an individual. For the poor, Medicaid is the only option.

So far, eight states have said they will turn down the expansion, while 13 states plus the District of Columbia have indicated they will accept it. The eight declining are Alabama, Georgia, Louisiana, Maine, Mississippi, Oklahoma, South Carolina, and Texas.

Nearly 2.8 million people would remain uninsured in those states, according to Urban Institute estimates, with Texas alone accounting for close to half the total.

Health and Human Services Secretary Kathleen Sebelius says states can take all the time they need to decide. They can even sign up for the first three years of the expansion and dropping out later.

But she hasn’t answered the one question that many states have: Would the Obama administration allow them to expand Medicaid just part way, taking in only people below the poverty line?

That means other low-income people currently eligible would be covered entirely on the federal government’s dime, and they would be getting private coverage, which is costlier than Medicaid.