As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care

Well, just as we predicted.

The rationing of healthcare has begun.

Thanks Obama and thanks to all the ObamaCare supporters for this wonderful piece of legislation. It's a Christmas gift that keeps on giving...er...taketh away.

As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care

 

I can't believe they'd do something like this. A lot of people depend on Medicaid now. The law shouldn't have been structured to pull the rug out from under us just when we need it the most.

 

States just need to pass laws requiring providers to take a certain percentage of Medicaid patients, based on specialties and need as determined by States at Medicaid rates they can do that as a provision on holding licenses at all levels.

 

My thoughts are let the free market work.
Docs will compete against each other for non medicare and medicaid patients.
That costs money. Patients don't just magically show up at one primary care physician group over another.
Especially one that just refused service to someone's mother and father.

Marketing and sales. Docs haven't had to do a ton of that.
However, that changes when you decide to operate in a smaller prospect

Physician groups will find ways to revise their business plan to serve this ever growing market.
And that will include cost pressure up the line to drug companies and equipment manufacturers and professional services.
No way they won't want a piece of 1/5th of the US market.
Without them the competition for non medicare will be very expensive.

The health care industry is rife with economic insanity
Pressure from primary care physicians --- at the front line -- is a positive.

Does anyone doubt costs will continue to outpace inflation if there's a steady flow of $?
Does anyone doubt that the industry will figure out a way to make profit off of 68 million people?

Next up: The higher education industry.
Same choke needs to happen here.

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Note the word could in the original linked story.

We were also told unemployment would go up.
The deficit would go up.
Growth would grind to a halt.

Labeling a potential as disasterous is what the far right does.
And so far, on the ACA, they have been 180° dead wrong.

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MOD EDIT - Rule 3
The idea of pushing people who are smart enough to be whatever they want to be out of health care is really stupid. Should we also reduce the requirements in medical schools? That will get more people pretending to be doctors in the market.

If my skull is cracked and my brain is exposed I don't want someone who is distort over trying to keep his or her office open trying to keep me alive. I want them to arrive in an SL500 without another care in the world. ER room doctors make $300+ per hour for a reason. We need them to be able to focus of the holes in Little Rassad when he gets he gets a cap bushed in his ass. Or when I go in with a kidney stone like I did christmass morning I want them focused on my little problem.

Forcing the doctors to compete for scraps is crazy.

 

Bull(*)(*)(*)(*)! How about laws telling YOU to take less money for what YOU do?

 

Well, I hope the thing gets extended again, and perhaps made permanent somehow.

 

The impact of ACA runs very deep....

Iowa insurance co-op falters, is taken over by state

CoOportunity Health, a fledgling Iowa health-insurance company set up under the Affordable Care Act, is being taken over by the state health-insurance division because of a financial crunch.

CoOportunity Health is an insurance cooperative set up to give consumers and small businesses an alternative in a market with few choices. The company relied on tens of millions of dollars in federal loan guarantees provided under the Affordable Care Act, also known as Obamacare. It began selling policies in 2013.

Insurance Commissioner Nick Gerhart said Wednesday morning that CoOportunity Health has about 120,000 members in Iowa and Nebraska, and only has about $17 million in cash and assets. Gerhart said the company had expected more federal money but didn't receive it. "It's a difficult situation," he said.

Gerhart said customers' coverage will continue, but he expects most members will switch to other carriers by Feb. 15, the deadline for enrolling in 2015 coverage.

 

Amazing sense of arrogance, to mandate what Doctors should accept as payment.

Never mind the salaries of the employees in his/her office, the medical supplies, the rent, the insurances, the taxes, the rent on the medical machines, etc.. no, no, no, Doctors should treat and accept less money and then go out of business.

Amazing.

 

I'd like to see some margin pressure on the folks who service the primary care physician.
Rather than just continually raising the amount We The People pay, I think we need to shake up the system and let the market go to work.

Since the advent of Medicare, the costs for health care have far outpaced inflation.
When someone thinks the government will just increase payments to cover beyond inflationary rise in their own costs, they tend to not bother that much with the costs to them that are outpacing inflation. The result is a sloppy business model that has little cost control mechanisms.

When a doc only gets x for each medicare patient he/she sees, and if they want a piece of the ever-growing market share -- they will look at their models and vendors and start acting like the rest of us (who don't have the government paying all of our costs that outpace inflation) and figure out a way to make margin on x.
That's just the market at work.

Lots of people just want medicare and medicaid to go away.
Perhaps it should.

But I'm not willing to head that way until we get realistic at capping payments at something sensible as to the rate of inflation.

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Allowing doctors to not worry about the costs they incur that far outpace inflation by just having the government write a bigger check -- is also crazy.

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I have a number of large customers that simply won't pay rate card.
They know my margin may be less with the rates and fees they will pay, but I will more than make up for the lost revenue in margin.
What medicare and medicaid is doing is simply using their leverage.

There's no way I can support continually just writing bigger checks to cover costs that are far outpacing inflation.
That's just dumb.
We should use the leverage to allow the market to correct.

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This is a classic example to show that the ACA is not government run, but a market-based system.
Bad business models don't make it in a market-based system.

good.

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Obama postponed/delayed more than 30 key (most damaging) ObamaCare provisions.

Just wait until the full ObamaCare is allowed to be implemented.

 

Quite right... the whole half-assed "socialized medicine" fraud is going to unravel, crash, and burn. Those who will not or can not pay for their own medical treatment are going to end up in emergency rooms, medicare, "community health clinics" and things of that nature. But, ultimately, Obama and the Socialists will win on this issue.

You see, all along, this has been an intricate masquerade dance played by all participants to find a way to force taxpayers to pay for people who pay little or nothing! Jonathan Gruber and his Socialist benefactors in the Obama regime put this obviously unconstitutional pile of crap into law as a "mandate". It should have been struck down by the Supreme Court immediately, but instead, Chief "Justice" John Roberts re-wrote the thing as a "tax" instead, and only because of that, found that it was legal after all. It has been a criminal fraud from the first day of its existence, and as we go into 2015 and more and more people find out how much their costs have increased while the level of care has gone down, we'll probably see the whole thing taken out to the garbage pile where it belonged in the first place.

The irony? Obama promised that the average family would actually see a DECREASE of $2,500 per year in healthcare costs. This is what always happens when people put faith and trust in a lying, deceiving Socialist liberal like South Chicago's most famous community organizer.

The other irony? I've said that the Socialists will eventually win this issue. That's because the next "step" will be to single-payer healthcare -- BUT, this can actually be a good thing. One big caveat -- everybody must pay for it to be fair, and for it to work! It will entail a complete re-writing of the U. S. Tax Code, but everyone will be covered, everyone will pay, and costs will truly decrease a great deal because who has more buying-power than the combined population of the United States of America?! Anybody who won't pay, or can't pay will (and should) stay on Medicare or just go into the emergency rooms....

 

That is the intent of the ACA- to usher in a single payer gov controlled system.

All one needs to do is to look at the VA- that is America's future with healthcare. Except, except for those worthy beings who are either Rich or part of the Ruling Class Elites where you will have luxury care.

The rest of the us, the peons, will be herded into single payer. Doctors will be herded into hospitals and clinics, all run by the Government.

The days of a doctor hanging a sign outside his/her door are coming to a close.

 

Federally enforced and regulated system into the private market. A real winning combo.

 

I can't really tell--are you upset that the ACA increased the pay of primary care providers in the first place, or are you upset that the pay bump wasn't permanent?

The public payers finance most of the costs of training physicians in the U.S.--it wouldn't be that outrageous to then ask physicians to commit to seeing the patients insured by those public payers.

 

Well since banks get money insured from the FDIC and govt money goes towards mortgages via Fannie/Freddie and FHA, how about we regulate your pay? Better yet, how about the govt regulates everyone's pay since, using you logic, the govt funds damn hear everything we use in one form or another.

 

The sky is falling. The sky is falling. The sky is falling.
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Indeed, so far it has been.
Rate increases at the lowest in nearly a generation.
Unemployment down.
Ages finally trending up.
Deficit down
GDP growing.

All types of markets have regulations.
Regulations do not equate to socialism.
They equate to regulations.

I know you want them to be thought of as more.
But they are just regulations.
And regulations can and will be changed as necessary.

Not as dramatic as all of the prognostication the far evokes, but reality rarely is.

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It's not a tenuous link, as you're attempting to imply here. The government directly pays for the costs of training the nation's physicians.

Medicare and Medicaid contribute about a half a million dollars per resident to train these folks. Asking that they see Medicare and Medicaid patients once they complete their training seems unreasonable to you?

 

Do you have a link to support these 2 claims?

 

And per your own link, 'These trainees are a key part of the labor supply at these hospitals'. Now if that's the case, tell me what your proposal has to do with supplying hospitals with doctors. Now if you wish to tie this program into compelling doctors to accept Medicare/Medicaid patients you tell them upfront and you tell them what they will be reimbursed. Then they can either opt in or opt out of this program. And you tell them what they will be reimbursed and that the costs will never change. Sound fair?