“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.

Obamacare will not work! Trail runs in Hawaii and Massachusetts have failed miserably!

Did Not Work in Hawaii, Does not work in Massachusetts, and it will not work as a nation in whole! So…why is Obamacare even being attempted?

 

AP/ March 12, 2009, 3:30 PM

Hawaii Ending Universal Child Health Care

Hawaii is dropping the only state universal child health care program in the United States just seven months after it launched.

Gov. Linda Lingle's administration cited budget shortfalls and other available health care options for eliminating funding for the program.

A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

State officials said Thursday they will stop giving health coverage to the 2,000 children enrolled by Nov. 1, but private partner Hawaii Medical Service Association will pay to extend their coverage through the end of the year without government support.

"We're very disappointed in the state's decision, and it came as a complete surprise to us," said Jennifer Diesman, a spokeswoman for HMSA, the state's largest health care provider. "We believe the program is working, and given Hawaii's economic uncertainty, we don't think now is the time to cut all funding for this kind of program."

Hawaii lawmakers approved the health plan in 2007 as a way to ensure every child can get basic medical help. The Keiki (child) Care program aimed to cover every child from birth to 18 years old who didn't already have health insurance - mostly immigrants and members of lower-income families.

State health officials argued that most of the children enrolled in the universal child care program previously had private health insurance, indicating that it was helping those who didn't need it.

The U.S. is one of the few western countries that does not have universal health care, although many states have government programs to help parents cover their children.

Obamacare seeks to drown Physicians in bureaucracy! Physicians seek to quit Medicine (retire, walk-away, leave…)!

Obamacare seeks to drown Physicians in bureaucracy! Physicians seek to quit Medicine (retire, walk-away, leave…)! Will Americans have coverage….Maybe….will Americans get care…NOPE!

 Critical Condition

NRO’s health-care blog.

Good Luck Finding a Doctor under Obamacare

By  Grace-Marie Turner

July 30, 2012 6:49 PM  

“No matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period.”

President Barack Obama,

Speech to the American Medical Association

Chicago, June 15, 2009

In truth, prospects are bleak that you will be able to keep your doctor and even bleaker that there will be enough doctors to meet demand under Obamacare.

The health overhaul law expands health insurance to millions more people without significantly increasing the number of physicians or other providers. And Obamacare has exacerbated the physician shortage because many are considering leavingthe practice of medicine altogether rather than practice under the dictates of Washington bureaucracies.

An Investor’s Business Daily/TIPP survey conducted in September of 2009 found that 45 percent of doctors said they “would consider leaving their practice or taking an early retirement” if the health law stands.

More than 800,000 doctors were practicing in 2006, according to government data. Projecting the poll’s finding onto that population means that 360,000 doctors would consider quitting!

And even without a mass exodus, the Association of American Medical Colleges envisions a shortageof about 160,000 doctors by 2025.

The greatest tragedy of Obamacare may be losing prematurely a generation of the most highly-trained, skilled physicians in history to a health overhaul law that the American people did everything they could to stop.

Physicians say they simply won’t practice under Obamacare rules that strip away much of their autonomy, drown them in bureaucracy, and leave them even more exposed to lawsuits.

Health care already is one of the most highly-regulated industries in the country, and doctors and nurses are forced to devote a significant amount of their day to detailed paperwork, adding to their frustration and taking away from time with patients. Reporting requirements will increase significantly under the health overhaul law, and the penalties for those who run afoul of the avalanche of new rules also will increase.

The supply of doctors will dwindle as demand for services reaches an all-time high. Fewer of those in private practice are taking patients on Medicare, and even fewer can afford to see the millions of new patients likely to be enrolled in Medicaid. 

By increasing demand for care without a comparable increase in the supply of doctors to treat the additional infusion of patients, the law will exacerbate the current physician shortage, as the New York Times reportedon Sunday.   

“In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014,” the Times reports.

“But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now. Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems,” according to the article.

Shortly after the law was passed, an April 2010 survey of physicians, conducted by Athena Health and Sermo, foundthat 79 percent of physicians were less optimistic about the future of medicine; 66 percent said they would consider dropping out of government health programs; and 53 percent would consider opting out of insurance altogether.

In August of 2010, The Physicians Foundation completed another major survey of doctors and found that:

•  67% of doctors had a “somewhat” or “very” negative initial reaction to the new law
• 74% said they would take steps to change their medical practice over the next one to three years
• 60% of these doctors said that the new law will force them to close or restrict certain categories of patients: 93% will stop seeing or restrict the number of Medicaid patients they see, and 87% will close or restrict their Medicare practice.
• Ominously, 89% of physicians said that they believed that the survival of the traditional model of independent private medical practice is threatened. In fact, hospitals already ownmore than half of medical practices, and that unwelcome trend will be accelerated under the new health law.

Seniors are most at risk because they have the greatest need for medical care. The health law takes more than $700 billion out of Medicare to finance new health-insurance spending, primarily by cutting payments to physicians and Medicare Advantage health plans.

If these cuts were to stand, experts at the Centers for Medicare and Medicaid Services say the number of hospitals, nursing homes, and hospice centers facing financial losses under the new law would jump to “roughly” 25 percent in 2030 and 40 percent by 2050. Many Medicare providers will be forced to either stop seeing Medicare patients or go bankrupt entirely.

Doctors are quietly making their plans now to restructure their practices, retire early, get another job, or otherwise protect themselves from the coming regulatory avalanche and payment cuts. 

Ultimately, the consequences of the health overhaul law will be passed along to patients through restricted access, long waits for appointments, and rationed care. It’s up to the voters in November to pull the emergency brake, that last chance to stop the Obamacare freight train.