Archive for October 2013

ObamaCare Consequences

October 27, 2013

Ok. maybe i should have posted this earlier and it just seems that i am piling on, but i wanted to hear what people are hearing and saying so that i can contribute to what is not known out there. so what i hope to add from this post is a small bit of back-end, inside baseball information that you can share with this info with others.

I went to a recent meeting where a medical billing expert (who is on a CMS expert panel) discusses the history of coding and how the government rules and regulations try to define, label, codify, and value the work that healthcare providers provide. In discussions we shared with each other a few informative tidbits…Because everyone is going to get healthcare, there will be an increase in demand, but the supply of professionals is limited…the question that has to be asked is where are we going to get the professionals to provide the services?…the government answer is really easy…we will just lower the threshold for medical acceptance entrance exams of those people who sign a statement that they will be going into primary care. i predict that the ‘quality, affordable healthcare’ from the PCP, primary care provider, will come from newly minted lowered standard physicians or nurse practitioners or even physician assistants. That is the healthcare future for all…not only that…

Several months ago a colleague of mine was recruited by sales people to join the new Obamacare Medical ‘construct.’ President Obama’s wonderful new model for affordable healthcare, called Accountable Care Organizations, is going to reward those involved in the ACO for taking “good” care of patients and financially penalizing for not doing a “good, or good enough” job.

1. if this was such a wonderful thing, why do they need salespeople to sell this to the providers? to rope them in?
2. it sounds like Obamacare is just repackaging the HMO concept, only now it will cost the providers if the patients are non-compliant “bad” or “difficult” or complicated patients; how is that supposed to incentivize the best?
3. at the top of the ACOs, the organizing entity around which all services revolve is the hospital. hospitals are run by MBAs whose bottom line is shareholders and their own salaries, benefits and parachutes. they have no compunction about charging over 600% for a tylenol tablet to a post-surgical patient because they are sick, whereas in most doctors offices, we buy the tylenol ourselves and give it to the patients who need them, so they feel better (and we generally do not charge, we bundle it up as part of the full visit).

some things for you all to discuss…there is probably more i can share with you, more inside baseball stuff…i think this is good enough for now, so you can all stew over it a bit…