Stanley Feld M.D.,FACP,MACE
I have discussed the disillusionment of Obamacare by several
major stakeholders, hospital systems, insurance companies, union leaders and
large corporations in my last three blog posts.
As Obamacare gets more complicated physicians are opting out of Medicare and will
not participate in Obamacare.
All most physicians want is to practice the best medicine they can
using their intellectual property or surgical skills.
Physicians are people who want to help people. They are not street
Obamacare is trying to commoditize medical care, decrease physician
value and reimbursement.
Commoditization of medical care will decrease physicians’ freedom to
exercise their medical judgment. Medical decision-making will be in the hands
of distant involved bureaucrats. Access to care will be determined by
bureaucratic rules and not the patients and their physicians.
Physicians are opting out of Medicare, Medicaid and
Obamacare. They have become totally frustrated
with Medicare and Medicaid reimbursement rates and the mounting rules and
Marilyn B. Tavenner R.N., the
administrator of the Centers for Medicare and Medicaid Services told congress
that an insignificant number of physicians have dropped out of Medicare and
Medicaid. This is clearly not true.
CMS report said 9,539 physicians who had accepted Medicare in the past opted
out of the program in 2012, up from 3,700 in 2009. That compares with 685,000
doctors who were enrolled as participating physicians in Medicare last year,
according to CMS, which has never released annual opt-out figures before.
The number of physicians opting out of Medicare last year
nearly tripled from three years earlier, according to the Centers for Medicare
and Medicaid Services.
This is not an insignificant number of physicians when
America is experiencing a shortage of primary care physicians.
“A study in the
journal Health Affairs this month found that 33% of primary-care physicians
didn't accept new Medicaid patients in 2010-2011,” even though they continue to participate
Some physicians are limiting the number of Medicare patients
they treat even if they don't formally opt out of the system.
The reason is Medicare reimbursement is so low and getting
lower. It some cases reimbursement is lower that the cost to deliver the care.
A study found that 4%
of family physicians are now in cash-only or concierge practices.
The Obama administration issued an
executive order this year where Medicare would not reimburse anything to
patients paying cash to non-participating physicians.
This is putting an increased burden on Medicare patients.
The Obama administration’s bureaucrats are not facing
reality. Today, before the expansion of Medicaid it is difficult for Medicare
and Medicaid patients to find a physician.
president of the Medicare Rights Center, said his patient-advocacy group has
had an increase in calls from seniors who can't find doctors willing to treat
Many physicians will not accept Medicaid patients. CMS
administrators want the public to believe this is not true. They say the number
of physicians not taking Medicaid is insignificant.
Medicaid physicians have to see as many as 200 patients or
more a day to make a living. There are
not enough minutes in a day to see that many patients and have a quality care visit.
These physicians have employees who are seeing patients for them. These
physicians then sign off as seeing the patient.
This volume then triggers a probe on their practices and
accusations of fraud. As Medicaid gets expanded through Obamacare to cover the
uninsured, there will be even fewer and fewer Medicaid physicians and a greater
Medicaid physicians are not interested nor can they take the
Employers are cutting back on hiring full time employees and
hiring part time employees to avoid the rising insurance costs.
Marilyn B. Tavenner, the administrator of the
Centers for Medicare and Medicaid Services, told Congress that she
had heard of only “isolated incidents” in which employers tried to cut back
hours. Representative Steve Scalise, Republican of Louisiana, told her that she
must be “living in some cocoon” because he heard of such actions almost every
Every large corporation is converting as many
full time workers to part-time workers as possible because of Obamacare in
order to avoid the Obamacare mandate. Part-time workers have felt the
disastrous impact on wealth production and economic activity.
survey showed a gain of 162,000 jobs. The previous two months were revised
lower. The employment change for May revised down by 19,000 (from +195,000 to
+176,000), and the employment change for June revised down by 7,000 (from
+195,000 to +188,000). The unemployment rate dropped 0.2 to 7.4%. Explaining
the Unemployment Rate Drop
rose by 227,000 of which 103,000 were part-time jobs.
- The Civilian Labor
Force Declined by 37,000 even though population rose by 204,000.
- Those "Not in
Labor Force" rose by 240,000.
- Participation Rate
fell 0.1 to 63.4%, a mere 0.1 higher than the low of 63.3% dating back to 1979.
July BLS Jobs
Statistics at a Glance
+162,000 – Establishment Survey
- US Employment +227,000
– Household Survey
- US Unemployment
-263,000 – Household Survey
- Involuntary Part-Time Work +19,000 –
- Voluntary Part-Time Work +84,000 –
- Baseline Unemployment
Rate -0.2 – Household Survey
- U-6 unemployment -0.3
to 14.0% – Household Survey
- Civilian Labor Force
-37,000 – Household Survey
- Not in Labor Force
-240,000 – Household Survey
- Participation Rate
-0.1 at 63.4 – Household Survey
Marilyn B. Tavenner making the above statement to congress
makes her a liar or a person not in touch with reality. Have can the American
people entrust our healthcare decisions to these bureaucrats?
The Obama administration needs both the primary and
secondary stakeholders’ cooperation if Obamacare has the slightest chance of
I do not think Obamacare can survive. It will sink under its
own weight as it tries to control all of the stakeholders through oppressive
regulations without regard for their vested interests.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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