HOW TO MAKE DENYING ACCESS TO HEALTH CARE TO 80% OF AMERICANS IS A GOOD THING: It seems the problems with Medicare was all those pesky patients taking too much time in the doctor's office and hospitals----
'health analysts now believe that Medicare spending through 2022 may end up being $700 billion lower than initially projected'.
HMMMMMMMMM.....isn't that the same amount of the cuts to Medicare by austerity? What about the trillions of dollars in Medicare and health industry fraud last decade?
As this attached article shows-----the reasons costs have declined is the policies of Affordable Care Act that make health care impossible to access for a majority of people. And that is a good thing? Remember, US health care costs are driven by health industry fraud and profiteering which by the way is now soaring. So, the decline is the fact that the average citizen can no longer access ordinary health care. You can pretend that moving everyone to preventative care and out of emergency rooms is a good thing if you do not care that 80% of Americans will see their lifespans drop by 10-20 years from this lack of access. So, health costs drop because now less than 20% of Americans are accessing the level of health care we all have known in modern history. THAT IS A GOOD THING? It's like calling Clinton's surplus from ending Welfare and creating the largest and broadest poverty in US history 'a good thing'. Cutting a trillion dollars from Medicare and Medicaid is the face of these cost declines as are the super-sized deductibles and co-pays that have people paying insurance premiums and then not affording to access the care. It is well known that the policy of covering pre-existing conditions has been mitigated by the health industry by these high deductibles and co-pays as well as making it hard to find a doctor or hospital when care is needed. The point is that patient access of care was never the driver of these health costs----it was the fraud and profiteering and as with any Republican policy-----Affordable Care Act is simply a means to maximize profit on the backs of labor and justice!
YEAH!!!!!! HUNDREDS OF BILLIONS ARE BEING SAVED FROM THE MEDICARE TRUST BECAUSE SENIORS CANNOT AFFORD TO ACCESS CARE AND MOST PEOPLE HAVE BEEN PUSHED TO PREVENTATIVE CARE ONLY! WHAT'S NOT TO LIKE ABOUT THAT!
And yet, health industry profits are soaring from all that 'EFFICIENCY'.
Why Health Care Costs Continue To Slow Down So Dramatically
by Tara Culp-Ressler Posted on January 6, 2014 at 4:00 pm
National health care costs rose by just 3.7 percent in 2012, according to a new report from the Centers for Medicare and Medicaid Services (CMS) published on Monday. The annual growth in medical costs has been slowing dramatically in recent years, with huge implications for reducing the projected national debt. According to CMS, the spending growth between 2009 and 2012 is the lowest ever recorded in the past five decades — and 2012 is the first time in more than a decade that health spending grew more slowly than the U.S. economy.
CMS’s data falls in line with a White House report released in November that found prices in the health care sector have been rising by 50-year lows since 2010. It’s still too early to determine exactly what’s causing the remarkable slowdown, but experts believe it could be due to a combination of several factors:
The ongoing impact of the economic recession: The country is still feeling the effects of the Great Recession, and more people are being forced to skip out on health care because they can’t afford it. When the November report was first released, Republicans claimed the sluggish economy was the primary reason for the recent slowdown in health costs, while the White House argued that other structural reforms to the health industry under Obamacare are now playing a greater role. This is still up for debate. Several outside reports have suggested the recession doesn’t explain the slowdown on its own.
More affordable prescription drugs: Spending on prescription drugs has continued to slow over the past several years, largely because of the rise of cheaper generic drugs. Several big-name drugs like Lipitor and Plavix lost their patent protections in 2011 and 2012, allowing cheaper alternatives to enter the market. Obamacare also makes reforms to Medicare’s prescription drug program, closing the so-called “donut hole” coverage gap so more seniors can afford their drugs.
More people enrolling in high-deductible plans: Increasing numbers of employers are beginning to offer high-deductible plans to their workers as a method of cutting down on health costs. These type of plans offer high out-of-pocket costs coupled with low premiums, which helps reduce costs in the private market. But they also end up shifting more health costs onto workers, and often lead people to skip out on health services because the co-pays are too expensive.
Relatively stable premiums: In addition to lower premiums resulting from high-deductible plans, overall premiums in the private insurance market didn’t skyrocket in 2012. CMS attributes part of that to low growth in enrollment. Insurers also may be doing their part to keep costs down, and government data suggests that fewer companies are requesting double-digit premium hikes — perhaps partly because of an Obamacare provision that requires them to spend 80 percent of their premium costs on delivering health care.
Reforms to Medicare’s payment structure: Spending growth in nursing home and retirement communities slowed in 2012, largely because of a one-time Medicare payment reduction to offset big increases in 2011. The Affordable Care Act also reduces the reimbursement rates to Medicare providers as a method of improving the quality and efficiency of care.
The CMS’ report isn’t giving the Affordable Care Act much credit, citing the economic downturn as the primary factor in the recent trend. According to CMS, Obamacare had a “minimal impact on aggregate health spending through 2012,” although the effects of the health law’s individual provisions may have helped impact some of the “subcompenents of national health expenditures.” Although it’s too soon to tell the long-term impact that the Affordable Care Act may have on health costs, the continued slowdown does contradict Obamacare critics’ initial claims that the law would dramatically increase health spending.
If this trajectory continues, the government could end up saving billions. For instance, health analysts now believe that Medicare spending through 2022 may end up being $700 billion lower than initially projected.
You could live in a cave in Kenya and still receive the saturation of media advertisements for Medicare options during this fall selection period for seniors. All kinds of 'health system specialists' are guiding people to the most affordable plans and as we all know by the policies of the Affordable Care Act-----the Federal plan has been cut so much as to deny coverage of some of the most popular health coverage. It moves people to select generic medications. Then, in steps the privatized version of Medicare----Medicare Advantage. Just by coincidence these private plans are now covering all those things the Federal plan doesn't and it costs almost the same. How do they do that? They subside the costs for some coverage by charging more for others. The goal is to make the conditions such that the 80% of people near or at poverty move to these private Medicare plans as the Federal plans are ended. WELL, NO ONE IS USING FEDERAL MEDICARE SO WE ARE GOING WITH THE MOST EFFICIENT PLANS----PRIVATE MEDICARE. Then, as with all public services privatized----there goes the coverage and quality.
THAT'S THE PLAN CLINTON NEO-LIBERALS HAVE FOR ENDING MEDICARE AND MEDICAID. IT IS THE REPUBLICAN POLICY WRITTEN DECADES AGO.
Note, even the billion dollar cuts to private Medicare Advantage never happened. ACA totally places all incentives for people to move to these privatized plans. In Baltimore, we have all major hospital systems embracing Humana and Kaiser Permenente both of which focus heavily on Medicare Advantage.
30% RISE IN PRIVATIZED MEDICARE ADVANTAGE BECAUSE CHANGES IN MEDICARE BY THE AFFORDABLE CARE ACT TAKE AWAY LOTS OF COVERAGE PEOPLE NEED.
Obamacare’s Reviled Medicare Cuts Have Turned Out Better Than Expected
While glitches continue to trouble insurance exchanges, another controversial part of the law has been a surprising success
By Kate Pickert @katepickertOct. 14, 2013
While the new Obamacare insurance marketplaces have been plagued by dysfunction, an existing coverage program curtailed by the health care law appears to be working quite well. In fact, it’s even more attractive to consumers than before reforms put in place by the Affordable Care Act (ACA).
Back in 2009 and 2010, one of the harshest criticisms of President Obama’s health care law was that it would hurt seniors. The law’s $700 billion in cuts to Medicare over 10 years would deprive seniors of benefits and choices, critics said. Of particular concern was the plan to cut more than $100 billion out of a quasi-governmental program called Medicare Advantage, which allows seniors to get government-funded private insurance plans in place of traditional Medicare.
Four years later, with the ACA in place, it appears that worries about the future of Medicare Advantage have not come to fruition — at least not yet. The program is more popular than ever. Between 2010 and 2013, enrollment in the program increased 30%, defying the expectations of some of the top policy experts in Washington.
But Republicans have not given up. Some still say the program is in jeopardy thanks to Obamacare. “The chances are that soon [seniors] will open up the mail to the bad news that your Medicare Advantage … has been changed in a negative way for you because of Obamacare,” said Senator Marco Rubio recently, even though premiums, plan choices and benefits under Medicare Advantage have remained stable even with less money for the program.
(MORE: Obamacare Chief Defends Rocky Start on The Daily Show)
“So far, the concerns have not been borne out,” says Tricia Neuman, a senior vice president at the Kaiser Family Foundation who studies Medicare Advantage. “Enrollment continues to climb. Some of the forecasts have predicted that plans would pull out and people would drop out — so far it hasn’t happened.”
When Medicare open enrollment begins on Oct. 15, the approximately 14 million seniors who choose Medicare Advantage will find options that are, in many cases, better and only marginally more expensive than in the past. According to the U.S. Department of Health and Human Services (HHS), which oversees Medicare, the average Medicare Advantage monthly premium will increase only $1.64 in 2014, compared with in 2013. Of benefits and cost sharing, Gretchen Jacobson, also of Kaiser, says, “We haven’t seen dramatic changes.” Authors of the ACA originally targeted Medicare Advantage for cuts because the federal government was spending about 14% more per enrollee in the program than for those enrolled in standard Medicare. The ACA’s cuts to the program began in 2012 and will continue until 2017.
But the program has been cushioned by a new HHS initiative that awards bonus payments to insurers selling higher-quality plans. While the bonus program was authorized by the ACA, the federal government increased its funding in 2012, drawing scrutiny from the Government Accountability Office. Some Republican lawmakers accused HHS of trying to mitigate negative effects of the ACA cuts before the 2012 elections. The payments may have softened the effects of cuts to Medicare Advantage, but the bonus payments totaled less than half of all cuts to the program so far under the ACA, according to Jacobson. In addition, the bonus payments may be responsible for the fact that more seniors will be enrolled next year in plans receiving four of five stars, in an HHS rating system, than in 2013.
While the full impact of Obamacare on Medicare Advantage cannot be measured until 2017, when all new cuts are in place, it appears that so far, the program has not suffered because of the law.
Below you see any policy that was placed in the Affordable Care Act meant to look to hold private health businesses accountable as the Federal Medicare was in losing $700 billion over tens years
has been repealed one by one. Medicare Advantage is the privatized Medicare supplement that competes with the Federal plan. The ACA used the excuse of the $700 billion in cuts to reclassify what Federal Medicare covers and it excludes some of the most needed health coverage. Meanwhile, with no cuts to Medicare Advantage----these private plans are simply offering all coverage that was cut from Federal Medicare. It's like a big box moving into your community and offering all kinds of low prices to put the other local businesses out of business to capture the market and once that happens----quality, service, and price savings disappear. That is what they are doing to Federal Medicare with the Affordable Care Act. It seems that with the changes to Medicare with the ACA----if you want all the coverage you need----you will have to move to private Medicare. They are saying private Medicare plans have jumped 30% with ACA.
RATHER THAN CUT PRIVATE MEDICARE PLANS AS WAS DONE TO FEDERAL MEDICARE-----THEY ARE NOW REVERSING THIS AND GIVING PRIVATE MEDICARE INCREASES HIGHER THAN WHAT WAS ASKED FOR.
'The Centers for Medicare and Medicaid Services on Monday, after proposing in February a 1.9 percent cut to private plans, said government payments to insurers in the Medicare Advantage program will increase .4 percent on average in 2015. The increase, CMS said, is slightly higher than what insurers had requested'.
BOY, I WAS REALLY WORRIED THAT PRIVATE MEDICARE WOULD BE HELD TO THE SAME STANDARDS AS FEDERAL MEDICARE MAKING THEM LESS ATTRACTIVE!
Obama administration reverses proposed cut to Medicare plans
By Jason Millman April 7 Washington Post
Daniel Acker/Bloomberg Medicare has reversed proposed payment cuts to private heath plans in the popular Medicare Advantage program for the second straight year amid strong pushback from health insurers and Capitol Hill.
The Centers for Medicare and Medicaid Services on Monday, after proposing in February a 1.9 percent cut to private plans, said government payments to insurers in the Medicare Advantage program will increase .4 percent on average in 2015. The increase, CMS said, is slightly higher than what insurers had requested.
"That gives us great confidence with this final rate structure we'll continue to see a strong program," said CMS principal deputy administrator Jonathan Blum.
The reversal comes after a major lobbying effort from the health insurance industry and signals that Republicans would use the cuts to attack Democrats in this year's midterm elections. The Medicare Advantage program, according to the Avalere Health consulting firm, now covers about 16 million seniors, or 30 percent of all Medicare beneficiaries, through private health plans that can offer extra benefits, like wellness plans.
CMS says it reversed the proposed cuts after reconsidering several factors. The agency had initially assumed Medicare’s growth rate would be -1.9 percent. Now it says that rate would be -3.4 percent, which actually would have lowered payments to health plans.
But because of various changes to how Medicare assesses risk, health plans will instead see higher payments, the agency says.
Medicare pays private insurers more per enrollee than the program pays for seniors under its traditional structure — a gap that the Affordable Care Act aims to eventually close. The president’s health-care law is expected to reduce Medicare Advantage funding by about $156 billion over a decade, according to a 2012 Congressional Budget Office projection. The health insurance industry has sharply criticized program cuts, contending that seniors will see reduced benefits and fewer health care choices as a result.
Medicare Advantage cuts required by the ACA started in 2012, and despite some dire predictions, enrollment in the program increased every year since the ACA was signed in 2010. The ACA's final cuts to the program are supposed to continue each year until 2017. The average monthly premium in 2014 plans were expected to increase $1.64 to $32.60, the Department of Health and Human Services announced last September.
CMS's reversal on Monday set off fresh Republican criticism of the planned future cuts to Medicare Advantage.
"It remains clear that these cuts will negatively impact seniors who will feel the harsh realities of the [Medicare Advantage] cuts," the House Ways and Means Committee Press Office said in a statement. House Speaker John A. Boehner (R-Ohio) said the reversal "does little to address the concerns about ObamaCare’s impact on the Medicare Advantage program that millions of seniors rely on every day." The Republican National Committee called the decision "political cover for vulnerable Democrats."
America’s Health Insurance Plans, the nation’s largest industry group representing health insurers, ran an aggressive lobbying effort last year that helped turn a proposed 2.3 percent cut for 2014 Medicare Advantage plans into a 3.3 percent raise. Insurers say other Medicare Advantage changes and cuts last year still reduced program funding by about 6 percent.
CMS justified last year's rate cut reversal largely by assuming Congress would act to avoid a major scheduled reimbursement cut to Medicare physicians, known as the “doc fix.” Congress has made 17 such patches in the past decade, including a year-long patch approved just last week. In setting 2015 rates, CMS again assumed Congress will patch Medicare physician payments after the latest extension runs out.
Insurers this year had started lobbying against the cuts earlier than ever. Their seven-figure campaign protesting expected cuts started in January, more than a month before Medicare even proposed rates.
About half of all the members of Congress, across party lines, raised concerns about the proposed cuts. A group of 40 Republican and Democratic senators, lead by Chuck Schumer (D-N.Y.) and Mike Crapo (R-Idaho), had called on CMS to maintain Medicare Advantage payment levels in 2015. Democrats had been especially fearful that the cuts would be used against vulnerable lawmakers in the November elections.
"In many parts of the country, including New York, Medicare Advantage works very well," Schumer said in a Monday evening statement. "They’ve shouldered their share already and this proposed cut would have been disproportionate, hurting seniors who would lose doctors or pay more. We’re glad the administration heeded our call and reversed the policy.”
Even after notching Monday’s victory, health insurers say they’re still worried about further cuts scheduled to hit Medicare Advantage.
“We remain concerned about the impact year-over-year cuts to Medicare Advantage would have on the high-quality, affordable coverage millions of seniors like and rely on today,” AHIP president and CEO Karen Ignagni said in a statement.
Monday’s rate announcement comes almost a month after the Obama administration abandoned proposed changes to the Medicare prescription drug program that drew widespread criticism from patient groups, insurers and Capitol Hill. CMS scrapped proposals that would have relaxed Medicare coverage requirements for some drugs, including antidepressants, and limited how many drug plans insurers could offer in the same region.
CMS on Monday also confirmed it will end a three-year quality bonus demonstration project that protected some Medicare Advantage plans from cuts required by the health-care law.
As you see above----most of the policy meant to place corporations on the hook for savings or cost sharing have been eliminated and most people probably don't know that because you did not hear saturated media coverage of this policy cancellation as media made great fanfare of these policies holding corporations accountable. Clinton neo-liberals never intended to hold corporations accountable----they handed health industry the power to determine the policies to absorb the $700 billion cuts to Medicare for goodness sake. All of the austerity cuts to health care came on the backs of seniors and the poor.
So, we know the Affordable Care Act supposedly closed the PHARMA loophole by paying more of the costs of drugs-------but wait-----what drugs are now covered by Medicare? It seems the biggest sellers are now no longer covered but a generic version may be.
Look below at what we see happening in record numbers-----class action lawsuits on drugs that have been a mainstay for seniors now found just as the patent was ending to cause serious side effects. So, are we really going to have a generic Lipitor or Plavix when FDA is taking the brand name off the shelves? Of course not.
Below you see the clip from the article above that toted the coming of generics to cheapen drug costs via Affordable Care Act ready to fund these generics. As you see, the FDA only took action to declare these drugs dangerous just as they were due for an end of patent. The generics will probably be allowed to continue TO SAVE COSTS IN PHARMA YOU KNOW!
'Several big-name drugs like Lipitor and Plavix lost their patent protections in 2011 and 2012, allowing cheaper alternatives to enter the market'.
Heart Attacks, Strokes, and Ulcers This Alert Affects: Any patient given Plavix as a blood thinner to combat blood clots, heart attacks, and strokes.
Heart attack, stroke, gastrointestinal bleeding, or ulcers. Those with a history of peptic ulcer disease have been reported to suffer bleeding
Company(ies)Bristol-Myers-Squibb / Sanofi-Aventis Additional DetailsLegal cases have now been launched. Generic versions of the drug, no longer in patent, remain in use.DateFDA concern reported in 1998. Plavix patent expired 2012.
Diabetes Lawsuit Several studies have shown that the drug Lipitor (atorvastatin) may cause diabetes, hyperglycemia, ketoacidosis, pancreatitis, and other serious side effects. Lawsuits are being filed alleging that Pfizer, the manufacturer of Lipitor, failed to warn doctors and patients about the side effects of Lipitor. We are offering free, no-obligation case evaluations for women who were taking Lipitor – at this time we are not investigating cases involving men. Contact us today to learn more about filing a Lipitor lawsuit.
What is Lipitor? Lipitor (atorvastatin) is a drug prescribed to treat high cholesterol. Manufactured by Pfizer, Lipitor is one of the highest selling drugs in the world with annual sales reaching $13 billion. Lipitor was approved by the FDA in 1996, and there are now generic equivalents in the market under the name atorvastatin.
Lipitor is in the class of drugs known as statins, which work by inhibiting the production of low density lipids (LDLs) that block arteries and lead to heart disease and heart attacks.
Lipitor Diabetes Lawsuit Lipitor has been linked to an increased risk of Type 2 Diabetes. A study by the University of Massachusetts showed that women taking Lipitor have a 48% higher risk of developing diabetes. The chance of developing diabetes from Lipitor is even higher in women with common risk factors such as obesity, high blood sugar, or family history of Diabetes.
We believe that Pfizer failed to warn doctors and patients about the serious risks associated with Lipitor, putting countless individuals at risk of developing diabetes and other serious side effects. Pfizer should be held accountable for their actions, and so we are filing Lipitor lawsuits on behalf of individuals who developed diabetes while taking Lipitor.
If you were taking Lipitor and developed diabetes, we urge you to contact our attorneys to discuss filing a Lipitor lawsuit against Pfizer. We are expert dangerous drug attorneys and have helped thousands of individuals receive financial compensation for injuries caused by dangerous drugs. Learn more about our dangerous drug experience or contact us today for a free case evaluation.
Lipitor FDA Warning In February 2012 the U.S. Food and Drug Administration added new warnings to the labels of Lipitor and other cholesterol drugs. The new warnings were based on the results from a study that showed statins may raise blood sugar levels, leading to memory loss and increasing the risk of developing Type II diabetes.
The article above shows how drugs that were commonly sold are now creating diseases in seniors that never existed before....diabetes on the rise in older populations. This is only one example of how cost and coverage are exclusive.
Below you see the myth of access by patients with chronic illness. Government subsidies provide help with premiums so you can buy a plan with high-deductibles. Diabetes patients have on average $5,000 in costs for everyday expenses and there is the $5,000 deductible. Seniors will be more pressed!
DO YOU REALLY HAVE COVERAGE IF YOU CANNOT ACCESS THE COVERAGE? OF COURSE NOT!
People will die because of lack of access to common health care -----70% of us citizens are at or near poverty and those percentages are rising fast!
May 21, 2014
Obamacare and Diabetes — Year Two
Cathy Carver, Vice President for Advocacy and Planning at Joslin Diabetes Center in Boston, advises people with diabetes to shop carefully for their insurance. The number of choices can be confusing. Interviewed on the site Type 2 Nation, Carver said,
Focus on three things when it comes to choosing a plan: a plan that doesn’t have high-deductible health insurance, a plan that covers diagnostic tests beyond the preventive screening tests…, and a plan that allows for educational services.
If you’re on insulin, I would ask about device and monitoring equipment coverage as well.
Because ACA gives government subsidies for buying insurance, your premium costs could be $60 a month or even less. But low-cost plans come with high deductibles, often in the range of $5,000 a year or more. So for most people, they are only useful in catastrophes like a motor vehicle accident. For someone with diabetes, basic maintenance and care won’t come to $5,000 a year. But if there are complications, you could reach that figure pretty quickly. So you might need to pay higher premiums for better coverage.
This article does a great job in showing what the shortfalls will be as Affordable Care Act continues. This doctor laments the damage consolidation does to free market. Indeed, the goal of ACA is to create global health systems that will act as any other monopoly---unaccountable and driven by profit. Fee for service has been derided as the cause of high cost---but that was because oversight and accountability was dismantled and health institutions were allowed to go wild with fraud. We all know creating global health systems and monopolies will not bring costs down for goodness sake!
As this doctor states, the cuts and policy changes to Medicare through ACA have made Medicare on par with Medicaid. THAT'S THE goal of ACA-------MEDICAID FOR ALL!
I DO Not agree with this doctor's alignment with free market health care.
Why Care Under The Affordable Care Act Will be Unaffordable
Richard Amerling, MD
By Author/Contributor, Richard Amerling, MD | Sep 28, 2012
Several recent articles should dispel any remaining notion that care provided under the so-called Affordable Care Act will in fact be affordable. Just the opposite is true.
The Wall Street Journal reported that when physicians sell their practice to hospitals and become hospital employees, services they provide to patients become significantly more expensive. The reason for this, simply put, is that overhead is much higher, and third parties reimburse at a higher rate for exactly the same service. Another way to say this is that hospitals are less efficient than a private office. And, as I have pointed out, physicians are considerably less productive when working for a salary, as opposed to fee-for-service. This was an entirely predictable outcome. Yet, health planners behind the ACA pinned their hopes for cost containment on exactly this consolidation occurring. The ACA promotes Accountable Care Organizations; groups of “providers” and administrators who will assume financial risk for caring for patients assigned to them, by accepting a lump sum payment to cover all their medical needs. ACOs are the latest version of managed care, and will have similar problems. They will have a strong financial incentive to cherry pick healthy patients; those with serious problems will end up in emergency rooms and hospitals, where care is much more costly.
Several recent articles should dispel any remaining notion that care provided under the so-called Affordable Care Act will in fact be affordable. Just the opposite is true.
This brings us to the most recent article from the New York Times, which shows that when hospital emergency rooms and physician practices adopt electronic health records, reimbursements for physician services goes way up. Wait a second! Isn’t the EHR the magic wand that is somehow going to result in huge efficiencies and cost savings? Well, not exactly. It seems doctors and hospitals are able to use the EHR to “enhance” documentation of patient encounters and services provided, which entitles them to “up-code” and receive higher reimbursement from third party payers. This game dates b ack to 1990 when Medicare adopted the “resource-based relative value scale,” a complex Stalinist system devised by Harvard PhD William Hsiao. It was an attempt to codify physicians’ work product based on time, effort, degree of training, patient complexity, and other factors. The “relative value units” for any given intervention would then be multiplied by a fixed number to assign a dollar value for that work.
To obtain reimbursement from Medicare under the RBRVS, doctors had to learn to code their encounters appropriately. (Yes, we had to take time away from our practices to attend ridiculous coding seminars!!). To bill for a “level 5 office visit,” for example, a detailed history, system review, and physical exam had to be performed, and documented. Of course, this is not always needed, even in complex patients, and the time required for documentation detracts from the quality of the encounter. The RBRVS was an absurdity, and hastened the medical profession’s march down the road to serfdom. Rather than oppose this intrusion, the American Medical Association colluded with the government to make it a reality.
With cuts and freezes, physician reimbursement under Medicare has shrunk to Medicaid levels and will decline further under the ACA. Payment in many instances barely covers the cost of providing care. Yet, doctors up-code at their peril. For years, the government has conducted random audits of private physicians, group practices, and hospitals, looking for claims with inadequate documentation in the medical record. Huge monetary settlements have been extorted based in differing interpretations of arcane regulations. The EHR provides templates and boilerplate text to automate documentation, and can be a bulwark against such audits.
In addition to effects on billing and payment, rigorous studies of actual implementation of health information technology show no cost savings or improvement in health outcomes, according to another WSJ article.
The ACA is an experiment in top-down social engineering of an extraordinarily complex field encompassing one sixth of our economy. It is destined to fail, and will be expensive beyond belief, in dollars, lost opportunity, and in misery. If only the free market were given a chance to deliver quality care at reasonable cost. In the few areas of health care where it has been allowed to flourish, it has done just that.
Richard Amerling, MD is a nephrologist practicing in New York City. He is an Associate Professor of clinical medicine at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is a Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians' Declaration of Independence.