Thanks, government health reform.......

This is the place where all heated debates shall reside. Non-tech topics allowed. Personal attacks will not be tolerated. "Enter at your own Risk".

Moderator: The Mod Squad

Thanks, government health reform.......

Postby fussnfeathers » Fri Feb 05, 2010 5:57 am

So I got calls from two of my three docs this morning. For those that didn't know, the government is requiring, as part of Obama's legislation, that all medical practices go to computerized billing. Fine, it is more efficient, somewhat, and it is nice having your records available at any doc's office in the country, as long as you don't mind that the government ALSO has access to those records. Here's the problem. The government charges $175,000 for the system, just for your office. You can't train an existing staff member to maintain the system, you have to hire a government trained employee, who, ironically, gets paid more than the doctor he's working for, you can't your patients more, and in fact, if you accept Medicaid or Medicare, you have to charge less, insurance payments are down now because of this (my primary care doc charges the insurance $50 per visit, he gets $10 from private, or $7 from government, plus any copays, which still only brings total payment up to half of what was charged)........both of these docs are starting to inform their patients that they will likely be going out of business, unless something drastic changes. We do have a clinician's group here, that's a coalition of city doctors, but they're going out of business as well, likely within the next six months. So, by this time next year, thanks to government regulation, I will have no healthcare available to me. Great. Hey, Obama, I'm showing up at the White House for my quarterly diabetes treatment, bipolar disorder treatment, neuropathy, and migraines.......hope you got room in the Oval Office for me, and your damn computer hooked up to the e-prescription service! Oh, yeah, quit denying my disability while you're at it. That would be awesome, thanks.
Faster than the speed of snot

Two wrongs don't make it right, but I sleep pretty good at night
fussnfeathers
Mobo-fu Master
Mobo-fu Master
 
Posts: 3147
Joined: Thu Dec 04, 2008 8:25 pm
Location: Right behind you

Postby thomas_w_bowman » Mon Feb 08, 2010 6:50 am

Started with HIPPA. I'm a Mainframe Contractor - and spent from 2000 to 2005 working to convert Minnesota and Iowa Medicare systems for the electronic medical submissions formats. It is the States that actually process as mandated by the government for Medicare (Medicaid, etc.), Minnesota spent tens of millions converting (as you are experiencing, with no discernable benefit for insurers nor medical practices), Iowa also spent plenty. The format was 'made up' during Clinton's administration as a giant step towards government taking over all health care in the Nation.
Meanwhile, laws were passed to prevent competition across State lines - again to nobody's benefit... Once that was passed, it appeared that Medical Insurance was certainly an issue for individual States to administer and control as they saw fit (no "Interstate Commerce" was allowed anymore - so what business would the Fed have regualting it ?).
The submissions system itself is strongly biased against Internists or Doctors doing a 'general' practice (Non-Specialty), and many Insurance Companies started requiring referrals for coverage (or 'better' coverage, such as 'In-Network', etc.). Billing and Insurance processing for payments was complicated enough, but now with 50 States making their own regulations and the Fed adding it's layer - small shops became incapable of handling the billing (many used service bureausor contracted it out) - I know of a practice that did mostly X-Rays, that was sent business from GPs (General Practitioners), that was no longer 'In-Network' (kind of like 'Preferred Vendors' for us Contractors, more overhead and less service) - so instead of a Doc being able to send a Patient upstairs to another office for an X-Ray ('right now') - for about $50... They now need to refer a patient to a huge Radiology/MRI HMO that not only needed appointments days, sometimes weeks in advance - but also would charge insurance more like $250 - the $avings are passed on to the policyholder... This inflated cost of insurance quite a bit.

Now we're being told that 'single payer' is "the answer", trouble is that the single payer premium has no relation to actual cost of administration - in fact it would be 'subsidized' by various unrelated new Taxes, like Carbon Credits raising our energy bills, etc. This proposed new 'solution' also assumes that we each need only specialists - and makes it tough for a GP to stay in business at all. Also, if administered by the Fed, it is nearly certain that despite increased taxes, it will fall into deficit spending - with the only way to 'control' cost being to ration care.

I had a time that I was unable to process insurance because they had an error in my Medicare file that resulted in many calls passing the buck ("press 1 for Spanish", "your estimated wait time is 35 in.", etc.). I eventually got one of my senators to investigate my case - which cleared up the error in several min. once I had a 'special' contact, because I'm the kind of persistant person that refuses to 'roll over and die'.

If we all die before eligible for Social Security, think of how much of the deficit that could help... Meanwhile the best small practices are folding up - my Doc was fired from a HMO for "taking too long on each patient", she was allowed 3 min. each. She works for a small practice and they are struggling, my medical history is still on paper (they use a service to handle billing). BTW discounts for cash pre-paying is illegal if they handle Medicare (Medicare must always get the 'lowest' price...).

Call your Congressperson and Senators while you might still make a difference - stop this Government takeover before it is 'official'.
Better living thru technology...
"Open the Pod Bay Doors, HAL..."
Join Folding team #: 33258
thomas_w_bowman
Black Belt 2nd Degree
Black Belt 2nd Degree
 
Posts: 2884
Joined: Fri Feb 28, 2003 2:59 pm
Location: Minneapolis, MN

Postby fussnfeathers » Mon Feb 08, 2010 9:54 am

Medicare/Medicaid billing is different. Docs have been able to bill electronically for quite some time, but all they need is the billing code for the treatment being charged, not your whole medical history. They can certainly request it if they feel something may have been improperly charged, but its still not the same as what I'm talking about. This is going to put everybody but the large, multi-doctor practices out of business. Its not a sliding scale, every facility pays the same. Not a problem for the hospital here, they had the budget and surpluses from donations to cover the $175,000 cost. My psychiatrist's office is one doc, and my mom (her lone office manager, receptionist, billing person, do-it-all Girl Friday)......now how's she supposed to cover that cost? She doesn't bring in that much per year to cover that kind of cost. My PC did it, and that's why they called me. There's an extremely high chance that he'll go under trying to pay the bill the government has forced on him, and it'll take me a year to find another PC that takes Medicaid. Same with my neurologist, one doc and one office person, and he sees a maximum of eight people a day, getting paid very little by insurance companies. He doesn't have the money. HIPPA and Medcaid compliancy was paid for by the State governments. This is being paid by the doctors, with no compensation or aid from the government mandating it. Big difference, there.

I can agree with the principle, but the implementation is just plain stupid. Medicaid did authorize me to go over to Dartmouth in NH if I need to, but that's gonna be a huge issue, since its a three hour drive, and I can't drive more than maybe ten miles. I'm just a kid at 40, what are all the retired folks going to do that rely on the local bus to get them to appointments, when they no longer have a doctor?
Faster than the speed of snot

Two wrongs don't make it right, but I sleep pretty good at night
fussnfeathers
Mobo-fu Master
Mobo-fu Master
 
Posts: 3147
Joined: Thu Dec 04, 2008 8:25 pm
Location: Right behind you

Postby thomas_w_bowman » Tue Feb 09, 2010 6:39 am

Some stuff, like CPAP supplies (after one has been through a 'study' - a sleep lab where they 'observe' patients choking due to obstruction, then wake them and adjust treatment) - REQUIRE periodic re-examination (which is known to increase BP, etc.) to keep getting supplies. Not only is the sleep lab night thousands of dollars - but they really want the patient to show serious symptoms before they focus on treatment - sometimes this is a very serious problem (apart from the expense and time):

Man dies during university sleep study
Sudden cardiac arrest: 'His heart stopped suddenly and without warning'
http://www.ajc.com/news/dekalb/coroner- ... ews_128746

Of course, we all 'trust' the Government with our sensitive data (not):
State prints Social Security numbers on envelopes
Health-care workers accidentally reveal 50,000 identities
http://www.sfgate.com/cgi-bin/article.c ... 1BUGN3.DTL

And the individual States can get 'heavyhanded' as well:

MN CHAMBER WANTS GOV'T IN YOUR EXAM ROOM

The Minnesota Chamber of Commerce today announced in an email that health care reform is their legislative priority: "2010
Legislative Priority: Implement health care reform," by Mike Bromelkamp, Chair of the Chamber's Health Policy Committee.
Unfortunately, in their 4-point MN health care proposal, they did not include a proposal to make sure most health care dollars stay
in the pockets of individuals where they can be wisely spent and sparingly.

Instead, their first point seeks to put government and executive bureaucrats in the driver's seat of health care decisions. The
Chamber wants the legislature to "Focus on quality vs. quantity of procedures." They want physicians and other health care
professionals to be paid not according to the work they do, but according to how patient outcomes match up to government-preferred
outcomes.

Think for a minute:
1) this proposal would require deep delving into the private medical records of patients
2) it makes assessment based only on data (he who makes his data look the best wins)
3) it makes the physician responsible for outcomes, when most outcomes depend on the patient (including physiological weaknesses, responses to treatment and genetic differences, and
4) imagine not being paid for what you do or for the hours you work, but only for the outcomes you achieve in relation to some government regulator's idea of a "good" outcome.

The Chamber's support for placing government regulators between patients and doctors is not a surprise. The Chamber has testified in
support of government-imposed "best practices" (2004) and against CCHC efforts to keep private medical records out of government
hands (2003). They also supported the 2008 reform law that requires private patient data to be submitted to the Minnesota Department
of Health for analysis, scoring of doctor performance, and imposition of financial penalties on doctors.


That means that by changing definition of a "good" outcome, the State can, in effect, implement massive Medicare cuts. And as you are experiencing, the Doctors can only absorb increased cost/reduced payments to a point...then they close clinics.

Still more reasons that Medical Insurance is going up while Medical care is not really improving...
Better living thru technology...
"Open the Pod Bay Doors, HAL..."
Join Folding team #: 33258
thomas_w_bowman
Black Belt 2nd Degree
Black Belt 2nd Degree
 
Posts: 2884
Joined: Fri Feb 28, 2003 2:59 pm
Location: Minneapolis, MN

Postby Roach412 » Tue Feb 09, 2010 12:07 pm

well...it is minnesota... :lol: :lol:

-Roach
Lian Li Lancool First Knight Series PC-K59W
Intel Core i7-960 Bloomfield 3.2GHz
EVGA X58 FTW3 132-GT-E768-TR
EVGA GeForce GTX 1070 FTW GAMING ACX 3.0
G.SKILL Ripjaws Series 12GB (3 x 4GB)
Crucial M4 128gb SATAIII SSD x2
Crucial M4 256gb SATAIII SSD
OCZ Saber 1000 960GB Enterprise SSD
Corsair Professional Series HX850 PSU
Dell UltraSharp U2713HM 27" w/drop ceiling mount
Logitech G930 7.1 Headset
DBPOWER RGB LED Keyboard
Logitech G402 Hyperion Fury
Roach412
Black Belt 2nd Degree
Black Belt 2nd Degree
 
Posts: 2714
Joined: Mon Aug 09, 2004 7:33 pm
Location: Milwaukee - Wisconsin

Postby thomas_w_bowman » Wed Feb 10, 2010 11:33 am

well...it is minnesota...


Red star of the North. :roll:
Better living thru technology...
"Open the Pod Bay Doors, HAL..."
Join Folding team #: 33258
thomas_w_bowman
Black Belt 2nd Degree
Black Belt 2nd Degree
 
Posts: 2884
Joined: Fri Feb 28, 2003 2:59 pm
Location: Minneapolis, MN

Postby fussnfeathers » Wed Feb 10, 2010 3:13 pm

thomas_w_bowman wrote:
well...it is minnesota...


Red star of the North. :roll:


Try Vermont on for size.
Faster than the speed of snot

Two wrongs don't make it right, but I sleep pretty good at night
fussnfeathers
Mobo-fu Master
Mobo-fu Master
 
Posts: 3147
Joined: Thu Dec 04, 2008 8:25 pm
Location: Right behind you


Return to The Hundred Year War

Who is online

Users browsing this forum: No registered users and 1 guest