Obamacare plus a lot of money from my pocket…..means I can keep my physician!

Did anyone really believe Obamacare was NOT going to change the relationship between physicians and patients? I like my doctor, I receive good care, and I do not need Obamacare screwing it up!

Obamacare Architect: If You Like Your Doctor, You Can Pay More

10:01 AM, Dec 8, 2013 • By DANIEL HALPER

If you want to keep your doctor, you might have to pay more for it, Obamacare architect Zeke Emanuel said today on Fox News Sunday:

The host, Chris Wallace, said: "President Obama famously promised, if you like your doctor, you can keep your doctor. Doesn't that turn out to be just as false, just as misleading, as his promise about if you like your plan, you can keep your plan? Isn't it a fact, sir, that a number, most, in fact, of the Obamacare health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?"

"The president never said you were going to have unlimited choice of any doctor in the country you want to go to," said the Obamacare architect.

"No. He asked a question. If you like your doctor, you can keep your doctor. Did he not say that, sir?"

"He didn't say you could have unlimited choice."

"It's a simple yes or no question. Did he say if you like your doctor, you can keep your doctor?"

"Yes. But look, if you want to pay more for an insurance company that covers your doctor, you can do that. This is a matter of choice. We know in all sorts of places you pay more for certain -- for a wider range of choices or wider range of benefits. The issue isn't the selective networks. People keep saying, Oh, the problem is you're going to have a selective network--"

"Well, if you lose your doctor or lose your hospital--"

"Let me just say something," said Emanuel. "People are going to have a choice as to whether they want to pay a certain amount for a selective network or pay more for a broader network."

"Which will mean your premiums will probably go up."

"They get that choice. That's a choice they always made."

"Which means your premium may go up over what you were paying so that, in other words –

"No one guaranteed you that your premium wouldn't increase. Premiums have been going up."

"The president guaranteed me I could keep my doctor," said Wallace.

"And if you want to, you can pay for it," said Emanuel.

Obamacare and Medicaid will bankrupt America, and real soon!

ObamaCare created a Medicaid time bomb

By Michael D. Tanner

December 7, 2013 | 9:15pm  NY Post 

The good news, if you want to call it that, is that roughly 1.6 million Americans have enrolled in ObamaCare so far.

The not-so-good news is that 1.46 million of them actually signed up for Medicaid. If that trend continues, it could bankrupt both federal and state governments.

Medicaid is already America’s third-largest government program, trailing only Social Security and Medicare, as a proportion of the federal budget. Almost 8 cents out of every dollar that the federal government spends goes to Medicaid. That’s more than $265 billion per year.

Indeed, already Social Security, Medicare and Medicaid account for 48% of federal spending. Within the next few years, those three programs will eat up more than half of federal expenditures.

And it’s going to get worse. Congress has shown no ability to reform Social Security or Medicare. With ObamaCare adding to Medicare spending, we are picking up speed on the road to insolvency.

The Congressional Budget Office projects that, in part because of ObamaCare, Medicaid spending will more than double over the next 10 years, topping $554 billion by 2023.

And that is just federal spending.

State governments pay another $160 billion for Medicaid today. For most states, Medicaid is the single-largest cost of government, crowding out education, transportation and everything else.

New York spent more than $15 billion on Medicaid last year, roughly 30% of all state expenditures. The Kaiser Foundation projects that over the next 10 years, New York taxpayers will shell out some $433 billion for the program.

But none of these projections foresaw that so many of ObamaCare’s enrollees would be Medicaid eligible.

To be sure, the health-care law’s designers saw the expansion of Medicaid as an important feature of their plan to expand coverage for the uninsured. Still, they expected most of those enrolling in ObamaCare to qualify for private (albeit subsidized) insurance.

It’s beginning to look like that was just another miscalculation, one that could have very serious consequences for the program’s costs.

Moreover, any projection of Medicaid’s future cost to New York taxpayers assumes that the federal government keeps its promise to pay 100% of the cost for Medicaid’s expansion over the next three years and 90% thereafter. But given the growing burden that Medicare will put on a federal budget already facing high debt levels, how likely is it that changes in the federal share of Medicaid will stay off the table?

In fact, as part if last December’s fiscal-cliff negotiations, the Obama administration briefly considered changing to a “blended” reimbursement rate, somewhere between the current and promised rates. The administration quickly backed away from the offer, but it’s likely to come back in the future. If it does, it would cost New York tens of millions of dollars.

Every bit as bad as the cost is the fact that for all this money, recipients are going to get pretty lousy health care.

Of course, one might say that even bad health care is better than no health care. But, unfortunately, for Medicaid, that’s not true.

The Oregon Health Insurance Exchange study, the first randomized controlled study of Medicaid outcomes, recently concluded that, while Medicaid increased medical spending increased from $3,300 to $4,400 per person, “Medicaid coverage generated no significant improvements in measured physical-health outcomes.”

Other studies show that, in some cases, Medicaid patients actually wait longer and receive worse care than the uninsured.

While Medicaid costs taxpayers a lot of money, it pays doctors very little. On average, Medicaid only reimburses doctors 72 cents out of each dollar of costs. ObamaCare does attempt to address this by temporarily increasing Medicaid reimbursements for primary-care doctors, but that increase expires at the end of next year.

Because of the low reimbursement, and the red tape that accompanies any government program, many doctors limit the number of Medicaid patients they serve, or even refuse to take Medicaid patients at all. An analysis published in Health Affairs found that only 69% of physicians accept Medicaid patients. A study published in the New England Journal of Medicine found that individuals posing as mothers of children with serious medical conditions were denied an appointment 66% of the time if they said that their child was on Medicaid (or the related CHIP), compared with 11% for private insurance — a ratio of 6 to 1.

Even when doctors do still treat Medicaid patients, they often have a harder time getting appointments and face longer wait times. One study found that among clinics that accepted both privately insured children and those enrolled in Medicaid, the average wait time for an appointment was 42 days for Medicaid compared to just 20 days for the privately insured. One study found that among clinics that accepted both privately insured children and those enrolled in Medicaid, the average wait time for an appointment was 42 days for Medicaid compared to just 20 days for the privately insured.

That’s one reason why so many Medicaid patients show up at the emergency room for treatment. They can’t find a doctor to treat them otherwise.

This not only increases the strain on already overburdened emergency room doctors, but increases the wait for those who arrive with real emergencies.

As bad as this is now, ObamaCare will make it worse by increasing the number of people on Medicaid without doing anything to increase the number of doctors treating them.

We don’t know yet whether the rush to Medicaid will continue. It may be that the troubles with the ObamaCare website might have skewed the early signups. But if ObamaCare really does lead to a massive expansion of this costly and inefficient program, that’s bad news for taxpayers, providers and patients.

Michael D. Tanner is a senior fellow at the Cato Institute.

 

Obamacare forces healthsystems and hospitals to cut staff!!! Obama seen nodding Approvingly

Top U.S. hospital laying off staff due to Obamacare!!!

Here it comes! Healthcare workers, Physicians, Nurses, PAs and NPs are being fired (health systems call it being laid-off). That means our care will suffer! No two ways about it!

Patrick Howley in the DailyCaller 11/25/13

The Cleveland Clinic, which is ranked among the top four U.S. hospitals, is making layoffs and cutting its budget more than $100 million as a direct result of the Affordable Care Act, the Daily Caller has learned.

“The cuts for 2014, about half of those are related to the Affordable Care Act…We anticipate a reduction in workforce” Cleveland Clinic executive director of communications Eileen Sheil said in an interview with TheDC.

The Cleveland Clinic is reducing its 2014 budget by $330 million.

“We offered early retirement to 3,000 employees,” Sheil said, but noted that the early retirement option recently offered to staff was “voluntary” for eligible employees.

“The $330 million cut is not all layoffs,” Sheil said, noting that the Clinic is also cutting operating-room expenses and paying less to vendors.

“We’re taking money out of vendors, renegotiating contracts, looking at where we can reduce duplications, improve supply chain efficiencies…how we can scale back and use less. How we can take costs out of our operating rooms,” Sheil said.

“We were able to take 23 percent out of common operations procedure by doing things more efficiently,” Shiel said.

The Cleveland Clinic is a Top 4 U.S. hospital for 2013-2014, according to U.S. News and World Report rankings. In 2008, Clinic surgeons performed the nation’s first near-total face transplant.

TheDC has extensively reported on Obamacare’s effect on hospitals, including hefty fines and other penalties facing nonprofit hospitals like the one that treated the final Boston Marathon bombing victim.

“Medicare Advisory Board”…Learn how to say it! These will be the people (the unknown bureaucrats) that will tell your doctor what treatment is best for you!

I want everyone to repeat after me….” Medicare Advisory Board (created by ObamaCare) will not let my doctor give me that treatment” Learn it, know it….love it! Because that is the way of the future! 

This is your life under ObamaCare

By Dr. Marc Siegel

Published July 03, 2012

FoxNews.com

Like all practicing physicians (and medical correspondents), I was glued to the news last Thursday morning at 10 am ET when the US Supreme Court via some questionable fancy legal footwork allowed ObamaCare to survive. Like many of my medical brethren, I was deeply disappointed by the outcome.

But ultimately I am not concerned about America’s doctors; we will survive even if our paperwork continues to pile up, our income continues to decline, and our waiting rooms overflow well beyond capacity. We may feel like quitting but most of us will soldier on, continuing to work even as the new Affordable Care Act committees regulate and restrict us to the point of impotence.

Most of us have no choice; we are super-specialized and we don’t know how to do much of anything else.

We will survive, but what about you, America’s patients? 

I am worried that the more than 250 million of you who already have health insurance will see the quality of care you receive diminish greatly. Doctors will weather the storm of ObamaCare even if we have to see a patient every five minutes and spend most of our time seeking test and treatment approvals, but what about you? How will you feel when you hear about a brand new cure only to find out that your insurance won’t cover it?

You, the patient, will have to get used to less access to real health care solutions, fewer approvals for the very latest, personalized, genetic-based cancer treatment or surgical technology that could save your life.

One of the reasons your doctor isn’t happy is because under ObamaCare he or she will bear the brunt of explaining how come your ever rising premiums are buying you less than they did before.
         
Gone will be the ability to pay out of pocket and receive a tax break for higher quality care. Flexible Spending Accounts will shrink to a maximum of $2,500 and you will only be able to deduct a medical expense from your taxes if it exceeds a whopping 10 percent of your gross income for the year.

With fewer cash payments, lower fees, and more red tape, no wonder your doctor isn’t happy. Recent surveys by Deloitte, sermo.com, and most recently Jackson Health Care reveal that a majority of doctors believe the Affordable Care Act will have a negative impact on their practices. Earlier this month the Doctor Patient Medical Association released a survey of doctors that showed that 90% believe that the health care system is on the wrong track.

Don’t get me wrong, covering you regardless of pre-existing condition with no possibility of your insurance dropping you when you are sick and no co-pay for preventive services are attractive features of ObamaCare.  But these expensive features have to be paid for with a "rob Peter to pay Paul" concept that comprehensive insurance is famous for.

You see, the ACA mandates the kind of expensive insurance that allows you to go to the doctor too easily; if insurance pays for people when they just want reassurance for a palpitation or an upper respiratory infection, it won’t have enough left to pay for expensive state-of-the-art treatment when a person is very ill.

Over the last few years I have diagnosed three cases of curable lung cancer using a screening Chest CT that I fear an Independent Medicare Advisory Board (created by ObamaCare) will deny in the future. I have also witnessed two patients waking from comas and walking out of the hospital long after ObamaCare’s new committees would likely recommend that their breathing tubes be pulled. I am concerned that ObamaCare rulings from on high will interfere with the art of medicine down here in the trenches.

It is one thing to provide a catastrophic insurance for everyone in case they end up in an emergency room, it is quite another to mandate the kind of insurance that restricts some services while blanketly approving others.

ObamaCare will cause your premiums to soar. ObamaCare promises to increase your access to health care but it may actually decrease it because your doctor will no longer have as much time for you. The growing numbers of insured will have difficulty finding a doctor. The current doctor shortage will be compounded by all the doctors who restrict the insurances they accept, beginning with Medicaid and Medicare.

Many physicians chose medicine, in the first place, because of the old-fashioned joy of taking care of people. I am afraid that joy is now in jeopardy. 

My patients are asking me the same question that patients all over the country are asking their doctors this week. "What do we do now?" Unfortunately, my answer, "I will be there for you no matter what," may not apply to all doctors.

 

New lawsuit will wipe the Obamacare law from the books! Then after that let’s just fix the existing system!

Did anyone involved with Obamacare proof read this law when it was a bill. America's health system isn't broken! It's being broken! 

All would agree our Healthcare delivery system could use a little fine-tuning on an ongoing basis!

This over all will be devastating for years to come for everyone!

Bombshell: Federal judge suddenly green-lights lawsuit that could stop Obamacare in its tracks

• Small-business plaintiffs say the government is treating all 50 states the same even though Congress allowed them to opt out – and 36 did
• The IRS is granting insurance subsidies to taxpayers in the 'refusenik' states, even though the text of the Obamacare law doesn't allow it
• A federal judge denied the government's motion to dismiss the case on Tuesday
• He also refused, however, to issue an injunction barring the Obama administration from implementing the law while the case moves forward

By David Martosko, U.s. Political Editor

PUBLISHED: 14:27 EST, 22 October 2013 | UPDATED: 15:05 EST, 22 October 2013

 

A federal judge on Tuesday refused to dismiss a case that could fatally cripple the Obamacare health insurance law.

The Affordable Care Act forbids the federal government from enforcing the law in any state that opted out of setting up its own health care exchange, according to a group of small businesses whose lawsuit got a key hearing Monday in federal court.

The Obama administration, according to their lawsuit, has ignored that language in the law, enforcing all of its provisions even in states where the federal government is operating the insurance marketplaces on the error-plagued Healthcare.gov website.

Thirty-six states chose not to set up their exchanges, a move that effectively froze Washington, D.C. out of the authority to pay subsidies and other pot-sweeteners to convince citizens in those states to buy medical insurance.

But the IRS overstepped its authority by paying subsidies in those states anyway, say the businesses and their lawyers.

 

 

The subsidies serve as a trigger that determines who has to comply with the now-famous individual and employer mandates. So, the lawsuit claims, the Obama administration illegally enforced the Affordable Care Act – suddenly making millions of taxpayers and small employers subject to paying fines if they don't play ball.

The Affordable Care Act authorizes subsidies only for policies purchased 'through an Exchange established by the State.'

A different section of the law empowers the federal government to set up its own exchanges for each state that chose not establish one.

 

But government lawyers have argued that 'Congress made clear that an exchange established by the federal government stands in the shoes of the exchange that a state chooses not to establish.'

The Treasury Department, they contend, 'has reasonably interpreted the Act to provide for eligibility for the premium tax credits for individuals in every state, regardless of which entity operates the exchange.'

But that amounts to the federal government ignoring the letter of the law, lawyer Sam Kazman says.

And 'without those subsidies, the employer mandate isn't triggered,' he told MailOnline.

And that could make the entire Obamacare system unsustainable.

 

 

Kazman is general counsel for the Competitive Enterprise Institute, a free-market think tank that is coordinating the case.

 

'The IRS cannot rewrite the law that Congress passed,' said Tom Miller, resident fellow at another think, the tank American Enterprise Institute.

'Its regulation expressly flouts the statutory text of the Affordable Care Act, the intent of Congress and the reasoned choices of [36] states.'

'The fiscal impact' of denying the Obamacare system millions of dollars in lost fines, 'while sizable, wouldn't be large enough to bring down the house,' Kazman added. The poltical one, however, is.'

'You'd have 34 "refusenik" states exempting their employers and many of their citizens from the employer mandate and portions of the individual mandate,' he explained.

'You'd have companies in participating states considering whether to move their operations' to states where they don't have to obey the Affordable Care Act. 'And you might even have some of those states seeking to undo their choice to participate.'

 

The Competitive Enterprise Institute said in a statement that the IRS and the Department of Health and Human Services have pushed regulations that Congress didn't authorize, forcing some employers 'to cut back employees' hours' in order to dodge Obamacare's more economically challenging requirements, 'even though they are located in states that have refused to set up their own insurance exchanges.'

U.S. District Judge Paul Friedman refused to dismiss the case, as the government requested, but also denied the plaintiffs' request for a preliminary injunction that would prohibit the IRS and HHS from granting subsidies in what lawyer Kazman calls 'refusenik' states.

Judge Friedman said Tuesday that he will rule on the merits of the case by February 15.

By then the Obamacare law will be in full swing, nearing the end of its open enrollment period and providing health care services to Americans who sign up for coverage by December 15.

Kazman said his organization would 'take an immediate appeal to the U.S. Court of Appeals' in order to get a re-hearing on the motion for an injunction to stop the clock on Obamacare while the larger legal issues are worked out.

At the lawsuit's heart is a set of distinctions that Congress drew between the 14 states – 15 including the District of Columbia – that chose to establish health insurance exchanges and the 36 that opted out.

The plaintiffs, who all hail from 'refusenik' states, say the federal government has invalidated their state governments' choices.

Kazman said that the Obamacare statute does not empower the IRS or HHS to 'give subsidy funding to people in states not authorized by Congress to receive it. That move, he agreed, had he effect of 'gutting a choice – to participate in the exchange program or not – that states were given by Congress.'

The government is 'asking you to interpret "north" to mean "south,"' plaintiffs’ attorney Michael Carvin told Judge Friedman on Monday.

The White House referred questions about the lawsuit to the Health and Human Services Department, which declined requests for comment and passed the buck to the Justice Department. The DOJ didn't respond to emails seeking a position on the lawsuit, which its lawyers are defending.

Obamacare causing recession and layoffs in Hospitals. Doctors, Nurses hit hard…The sick hit harder!

Obamacare reduces reimbursements…so Nurses, Administration, Physicians are losing their jobs. Ah…I was wondering just who will be taking care of the sick?

A job engine sputters as hospitals cut staff

Paul Davidson and Barbara Hansen, USA TODAY 8 a.m. EDT October 13, 2013

Hospitals are cutting thousands of jobs, undercutting a sector that was a reliable source of job growth, even through the recession.

Hospitals are reducing payrolls in the face of declining revenue even as the new health care law expands health insurance to more Americans.

Story Highlights

• Hospitals face lower insurance reimbursement
• New health care law encourages fewer hospital stays
• Twenty-six states rejected expanding Medicaid, a revenue source for hospitals

Hospitals, a reliable source of employment growth in the recession and its aftermath, are starting to cut thousands of jobs amid falling insurance payments and in-patient visits.

The payroll cuts are surprising because the Affordable Care Act (ACA), whose implementation took a big step forward this month, is eventually expected to provide health coverage to as many as 30 million additional Americans.

"While the rest of the U.S. economy is stabilizing or improving, health care is entering into a recession," says John Howser, assistant vice chancellor of Vanderbilt University Medical Center.

Health care providers announced more layoffs than any other industry last month — 8,128 — mostly because of reductions by hospitals, according to outplacement firm Challenger, Gray and Christmas. So far this year, the health care sector has announced 41,085 layoffs, the third-most behind financial and industrial companies.

Total private hospital employment is still up by 36,000 over the past 12 months, but it's down by 8,000 since April and more staff reductions are expected into next year.

This month, Indiana University Health laid off about 900 workers as part of a move to trim its budget by $1 billion over five years. Vanderbilt plans to eliminate 1,000 jobs by year-end to help shave operating costs 8% a year. And the Cleveland Clinic is offering buyouts to 3,000 employees as it shaves its annual operating costs by $330 million.

"This is a challenging time for the health care industry," says Jim Terwilliger, president of two of Indiana health's hospitals. "The pace of change is far greater than any time in recent history."

There are myriad reasons for the cuts, which are affecting administrative staff as well as nurses and doctors:

• Medicare, Medicaid and private insurance companies are all reducing reimbursement to hospitals. The federal budget cuts known as sequestration have cut Medicare reimbursement by 2%, the American Hospital Association says.

• The health care law has further reduced the Medicare payments to hospitals that provide lower-quality service or have high readmission rates.

• The National Institutes of Health reduced funding to hospitals by 5% as part of sequestration, forcing hospitals to trim research staff.

• The number of inpatient hospital days fell 4% from 2007 to 2011, in part because of the economic downturn, the hospital association says.

• As more Baby Boomers turn 65, their services will be reimbursed at Medicare rates that are lower than those of private payers, putting further pressure on hospital revenue.

The new health care law was supposed to ease the burden on hospitals by expanding Medicaid coverage to more low-income Americans, who often use hospital services in emergencies then don't pay their bills. But 26 states, including Tennessee, rejected ACA's offer of federal funding to expand Medicaid. That decision led to about a third of the job cuts by Nashville-based Vanderbilt, Howser says.

Still, J.P. Fingado, CEO of API Healthcare, a consulting firm for hospitals, says the layoffs are shortsighted because the providers likely will have to add staff as soon as next year to handle increased patient volumes resulting from the health care law.

"The cuts are a particularly short-term reaction," he says.

 

The Affordable Care Act cuts federal funding for hospitals that care for the poor!

The Affordable Care Act cuts federal funding for hospitals that care for the poor!

Health care law leaves Grady $45 million short

ATLANTA —

In an ironic twist, Grady Memorial Hospital faces a $45 million funding loss directly related to a new health care law designed to benefit the hospital.

The result could mean major cuts at Georgia's largest trauma center, according to Channel 2’s Lori Geary.

Danielle Words is an uninsured hospital patient who uses Grady as a safety net because it cares for thousands of uninsured Georgians.

“If I didn’t have this resource, I’d really be in big trouble,” Words said. “It’s very important to me.”

Words plans to sign up for health insurance under the Affordable Care Act because she qualifies in the insurance exchange.

Thousands more who are treated at Grady would have qualified for Medicaid, but Georgia chose not to expand the health care program.

“If Georgia were to expand, we estimate we'd have an additional 40,000 patients that would be eligible under the new rolled out expansion of Medicaid," Grady President and CEO John Haupert told Geary.

The Affordable Care Act also cut federal funding for hospitals that care for the poor, like Grady. The intent of the law was to expand Medicaid to offset those losses.

However, the U.S. Supreme Court left Medicaid expansion up to the states and Gov. Nathan Deal decided Georgia could not afford it.

"The impact to Grady when it's fully implemented will be a loss of $45 million a year in funding,” Haupert said.
  
The loss of funding means the hospital must prepare to cut clinical services.

“(It’s) obviously more than a haircut, right?” Haupert said.

Republican and Democratic lawmakers at the state Capitol are aware of the funding issues and are trying to work on solutions, according to Haupert.

New Jersey is loosing Physicians because of costs, crime, pay....Who knew?

Any Physician seeking to leave New Jersey please email me at dhadley@dbhadley.com

I can find and present you the practice you have always sought! Physicians that leave NJ are happy beyond belief. These physicians make more money, keep what they make, live in lower crime neighborhoods, find better schools for their kids, and save for retirement!

New Jersey’s Disappearing Doctors

 Posted: Sep 26, 2013 10:17 AM EDT

Updated: Sep 26, 2013 11:25 AM EDT

By Tamara Laine, @ChasingTamara

 

Neptune, New Jersey (My9NJ) -

New Jersey is experiencing a shortage of doctors. In fact, it’s projected that by 2020 the state will be about 3,000 primary care physicians short of what is needed to give optimal health care.

So why are doctors fleeing the Garden State?

According to Deborah Briggs, the President and CEO of the Council of Teaching Hospitals, New Jersey loses nearly 70% of the doctors it educates to other states. This is well below the national average of a 48% retention rate.

In other words, in 2013 New Jersey only kept about 34% of the doctors who were educated and trained in the state.

The Council of Teaching Hospitals and a nationwide study done by Merritt Hawkins, says New Jersey is just not competitive when it comes to keeping doctors in state.

The top five reasons for physicians leaving are:

·        Better salary offered outside of New Jersey

·        Cost of living in New Jersey

·        Better job/practice opportunities in desired locations outside of New Jersey

·        Taxes in New Jersey

·        Affordable Housing

Assemblywoman Amy Handlin and Assemblywoman Caroline Casagrande gathered doctors, residents, hospital managers, and specialist at Jersey Shore Medical Center to discuss New Jersey’s doctor drain.

The room was filled with 40 or so doctors who also added malpractice insurance issues to the list, explaining that it’s just too expensive to start a practice here.